====== Tubular Retractor System for cerebral arteriovenous malformation surgery ====== ==== 2023 ==== Five patients from a single institution were operated on for deep-seated AVMs using [[tubular retractor system]]s. Collected data included demographics, AVM specifications, preoperative neurological status, postoperative neurological status, and postoperative/intraoperative angiogram results. Five patients, ranging from age 10 to 45 years, underwent mini-craniotomy for stereotactically guided tubular retractor-assisted AVM resection using neuronavigation for selecting a safe operative corridor. No preoperative embolization was necessary. The mean maximum AVM nidal diameter was 8.2 mm. All deep-seated AVMs were completely resected without complications. All AVMs demonstrated complete obliteration on intraoperative angiogram and on 6-month follow-up angiogram. Minimally invasive tubular retractors are safe and present a promising surgical option for well-selected deep-seated AVMs. Furthermore, the study may elucidate whether tubular retractors improve outcomes after microsurgical AVM resection secondary to mitigation of iatrogenic retraction injury risk ((Achey R, Kashkoush A, Potter T, Davison M, Moore NZ, Kshettry VR, Bain M. Surgical Resection of Deep-Seated Arteriovenous Malformations Through Stereotactically Guided Tubular Retractor Systems: A Case Series. Oper Neurosurg (Hagerstown). 2023 Jan 23. doi: 10.1227/ons.0000000000000599. Epub ahead of print. PMID: 36716066.)). ---- 2: Mansour S, Echeverry N, Shapiro S, Snelling B. The Use of BrainPath Tubular Retractors in the Management of Deep Brain Lesions: A Review of Current Studies. World Neurosurg. 2020 Feb;134:155-163. doi: 10.1016/j.wneu.2019.08.218. Epub 2019 Sep 9. PMID: 31513954. 3: Witek AM, Moore NZ, Sebai MA, Bain MD. BrainPath-Mediated Resection of a Ruptured Subcortical Arteriovenous Malformation. Oper Neurosurg (Hagerstown). 2018 Jul 1;15(1):32-38. doi: 10.1093/ons/opx186. PMID: 28961981. 4: Fahim DK, Relyea K, Nayar VV, Fox BD, Whitehead WE, Curry DJ, Luerssen TG, Jea A. Transtubular microendoscopic approach for resection of a choroidal arteriovenous malformation. J Neurosurg Pediatr. 2009 Feb;3(2):101-4. doi: 10.3171/2008.11.PEDS08280. PMID: 19278307.