Unbled Cerebral Arteriovenous Malformations on Conservative Followup: Clinico-morphological Features, Natural History and Outcomes

Introduction: ARUBA trial was the first randomised controlled clinical trial assessing the outcomes from medical management with interventional therapy versus medical management alone, in patients diagnosed with an unruptured brain arteriovenous malformations. Detailed long term natural history of unbled untreated arteriovenous malformations and its correlation with clinicomorphological features has not been studied widely, especially from our subcontinent. Moreover, quality of life in these patients on conservative management is often not addressed adequately in many studies. In this study, we aimed to evaluate the mortality rate in unruptured AVM patients, who were managed conservatively on long term follow up, and additionally used a standard questionnaire to assess the QOL in these patients. Evaluation of primary outcome {death from any cause or symptomatic stroke (haemorrhage or infarction)} and secondary outcomes {neurological disability (Modified Rankin Scale ≥2) and other neurological symptoms} on long term followup have also not been extensively evaluated.