Clinical trial examines unruptured brain AVMs

Neurosurgeon and neurointerventionalist Vivek Deshmukh, M.D., FACS, and neurointensivist John Zurasky, M.D., are enrolling patients for the ARUBA study, a clinical trial examining treatments for unruptured brain arteriovenous malformations. The trial is sponsored by Columbia University and the National Institute of Neurological Disorders and Stroke.

Brain AVMs are abnormal tangles of arteries and veins usually formed at birth, but they also can result from head injury. In a normal vessel formation, blood moves from arteries to veins through a capillary bed, which effectively regulates flow pressure. In an AVM, the arteries and veins are connected directly without a capillary bed, exposing the thin-walled veins to high pressures and putting them at risk for rupture and bleeding.

Unruptured AVMs often are found incidentally, when patients present with nonspecific neurological symptoms such as headache, migraine, seizure or even trauma that prompts medical imaging.

The international, multicenter ARUBA study will help researchers understand which treatments best lower the risk of hemorrhage and lead to better long-term outcomes for patients with AVM. The study also will compare adverse events, quality of life and cost for medical management versus interventional treatment of AVMs.

Patients will be randomly assigned to a group receiving medical management alone, or to a group receiving both medical management and one or more interventional procedures. Study visits – by phone or at either Providence St. Vincent or Providence Portland medical centers – take place every six months for two years, then once a year for five to 10 years.

If your adult patient has been diagnosed with an AVM that has not yet ruptured, he or she may be eligible to participate in the ARUBA study. To learn more contact Monica Rodriguez, RN, 503-216-1190.