Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial

Introduction Intracranial arteriovenous malformations (AVMs) are associated with high morbidity and mortality. Modern microsurgery has improved the results of surgical treatment of AVMs; however, the treatment of AVMs, particularly eloquently located AVMs, still carries a high risk. Functional MRI (...

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Main Authors: Shuo Wang, Yuanli Zhao, Jun Wu, Bing Zhao, Yong Cao
Format: Article
Language:English
Published: BMJ Publishing Group 2014-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/4/10/e006618.full
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author Shuo Wang
Yuanli Zhao
Jun Wu
Bing Zhao
Yong Cao
author_facet Shuo Wang
Yuanli Zhao
Jun Wu
Bing Zhao
Yong Cao
author_sort Shuo Wang
collection DOAJ
description Introduction Intracranial arteriovenous malformations (AVMs) are associated with high morbidity and mortality. Modern microsurgery has improved the results of surgical treatment of AVMs; however, the treatment of AVMs, particularly eloquently located AVMs, still carries a high risk. Functional MRI (fMRI) has been reported to be used for the preoperative evaluation of AVMs in small case series. The purpose is to identify the utility and efficacy of fMRI-guided microsurgery of AVMs in a large randomised controlled trial.Methods and analysis The study is a prospective, randomised controlled clinical trial. This study will enrol a total of 600 eligible patients. These eligible patients will be randomised to the standard microsurgery group and the fMRI-guided microsurgery group in a 1:1 ratio. Patient baseline characteristics and AVM architecture and characteristics will be described. In the fMRI-guided group, fMRI mapping of an eloquent cortex in all AVMs will be identified. Surgical complications and outcomes at pretreatment, post-treatment, at discharge and at 1-month, 3-month and 6-month follow-up intervals will be analysed using the modified Rankin Scale (mRS). This trial will determine whether fMRI-guided microsurgery could improve outcomes in patients with AVMs and also identify the safety and efficacy of fMRI-guided microsurgery.Ethics and dissemination The study protocol and written informed consent were reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital Affiliated to Capital Medical University (ky2012-016-02). Study findings will be disseminated in the printed media.Trial registration number ClinicalTrials.gov NCT01758211.
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spelling doaj-art-5cf841b6906d47948719ccb111dc99432025-02-12T04:30:12ZengBMJ Publishing GroupBMJ Open2044-60552014-10-0141010.1136/bmjopen-2014-006618Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trialShuo Wang0Yuanli Zhao1Jun Wu2Bing Zhao3Yong Cao4Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaDepartment of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, ChinaDepartment of Neurosurgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, ChinaIntroduction Intracranial arteriovenous malformations (AVMs) are associated with high morbidity and mortality. Modern microsurgery has improved the results of surgical treatment of AVMs; however, the treatment of AVMs, particularly eloquently located AVMs, still carries a high risk. Functional MRI (fMRI) has been reported to be used for the preoperative evaluation of AVMs in small case series. The purpose is to identify the utility and efficacy of fMRI-guided microsurgery of AVMs in a large randomised controlled trial.Methods and analysis The study is a prospective, randomised controlled clinical trial. This study will enrol a total of 600 eligible patients. These eligible patients will be randomised to the standard microsurgery group and the fMRI-guided microsurgery group in a 1:1 ratio. Patient baseline characteristics and AVM architecture and characteristics will be described. In the fMRI-guided group, fMRI mapping of an eloquent cortex in all AVMs will be identified. Surgical complications and outcomes at pretreatment, post-treatment, at discharge and at 1-month, 3-month and 6-month follow-up intervals will be analysed using the modified Rankin Scale (mRS). This trial will determine whether fMRI-guided microsurgery could improve outcomes in patients with AVMs and also identify the safety and efficacy of fMRI-guided microsurgery.Ethics and dissemination The study protocol and written informed consent were reviewed and approved by the Institutional Review Board of Beijing Tiantan Hospital Affiliated to Capital Medical University (ky2012-016-02). Study findings will be disseminated in the printed media.Trial registration number ClinicalTrials.gov NCT01758211.https://bmjopen.bmj.com/content/4/10/e006618.full
spellingShingle Shuo Wang
Yuanli Zhao
Jun Wu
Bing Zhao
Yong Cao
Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial
BMJ Open
title Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial
title_full Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial
title_fullStr Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial
title_full_unstemmed Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial
title_short Functional MRI-guided microsurgery of intracranial arteriovenous malformations: study protocol for a randomised controlled trial
title_sort functional mri guided microsurgery of intracranial arteriovenous malformations study protocol for a randomised controlled trial
url https://bmjopen.bmj.com/content/4/10/e006618.full
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