Recently, the Department of Neurosurgery’s Grand Rounds featured a talk by Department Chair Dr. Robert A. Solomon. The title of the talk was “Surgical Resection of Cerebral Arteriovenous Malformations…Current Indications in the ARUBA Era”.
Dr. Solomon is particularly qualified to speak about cerebral arteriovenous malformations. His extensive research on cerebrovascular disease has led to the development of programs designed to protect the brain during cerebrovascular surgery. Dr. Solomon has specialized in the surgical treatment of cerebrovascular disease for more than 30 years.
If you’re wondering what cerebral arteriovenous malformations have to do with ARUBA, a sunny tropical paradise, the presentation wasn’t referencing that Aruba.
ARUBA is an acronym that stands for A Randomised trial of Unruptured Brain Arteriovenous malformations. This is a study that was done in 2013 by researchers who hoped that the results would help in the treatment of arteriovenous malformations. The basic premise of the study and what it seeks to prove is that interventions like surgery or radiotherapy do not offer better outcomes for patients than simply waiting and watching.
While there’s much to praise about the island of Aruba, Dr. Solomon says the ARUBA study is highly controversial. He, among many other neurosurgeons, does not support it.
Dr. Solomon believes the study over-simplifies the complex problems that arteriovenous malformations can present. Instead, he encourages the time-tested approach of evaluating each situation individually. Dr. Solomon believes that highly experienced doctors with access to a variety of options for treatment (such as gamma knife, embolization, or microsurgical resection all of which we have here) at CUMC are key to successful management of arteriovenous malformations.
The neurosurgeons who attended came away with something to think about, concerning the ARUBA study’s views on AVM treatment…but maybe we can all agree that Aruba is still a great vacation destination.
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