JAMA Network JAMA Neurology : Hemorrhage and Risk Factors in Unruptured Brain AVM
Oct 6, 2025
Helen Kim, PhD, a UCSF professor and director of the Center for Cerebrovascular Research, dives into the latest findings from the Multicenter Arteriovenous Malformation Research Study (MARS). She discusses the challenges in managing unruptured brain AVMs, revealing a significantly lower annual hemorrhage risk of about 1.4%, far less than previous estimates. Kim identifies high-risk patients based on age and associated aneurysms, and highlights the importance of this research for guiding treatment decisions and improving patient counseling.
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Clinical Dilemma Of Treating AVMs
- Helen Kim describes the clinical dilemma of weighing interventional treatment risks versus conservative management for AVMs.
- She highlights that ruptured AVMs require urgent intervention unlike many unruptured cases.
Large International Cohort Improves Validity
- The MARS study pooled data from nine international cohorts to capture a representative unruptured AVM population.
- This multicenter approach improved generalizability versus prior small single-center studies.
Gather Standardized Risk Variables
- Collect readily available clinical and angiographic variables across centers when assessing AVM risk.
- Focus on demographics, presentation symptoms, comorbidities, modifiable factors, and AVM location and aneurysm status.