Endovascular Management of Arteriovenous Malformations of the Brain

Abstract

Arteriovenous malformations (AVMs) of the brain are rare, complex, vascular lesions that can result in significant morbidity and mortality. Modern treatment of brain AVMs is a multimodality endeavor, requiring a multidisciplinary team with expertise in cerebrovascular neurosurgery, endovascular intervention, and radiation therapy in order to provide all therapeutic options and determine the most appropriate treatment regimen depending on patient characteristics and AVM morphology. Current therapeutic options include microsurgical resection, radiosurgery (focused radiation), and endovascular embolization. Endovascular embolization is primarily used as a preoperative adjuvant before microsurgery or radiosurgery. Palliative embolization has been used successfully to reduce the risk of hemorrhage, alleviate clinical symptoms, and preserve or improve neurological function in inoperable or nonradiosurgical AVMs. Less frequently, embolization is used as ‘primary therapy' particularly for smaller, surgically difficult lesions. Current embolic agents used to treat brain AVMs include both solid and liquid agents. Liquid agents including N-butyl cyanoacrylate and Onyx are the most commonly used agents. As newer embolic agents become available and as microcatheter technology improves, the role of endovascular treatment for brain AVMs will likely expand.

Journal

Journal ID (publisher-id): INE

Journal ID (pmc): INE

Journal ID (doi): 10.1159/issn.1664-5545

Title: Interventional Neurology

Publisher: S. Karger AG

ISSN (Print): 1664-9737

ISSN (Electronic): 1664-5545

Publication date Subscription-year: 2012

Publication date (Print): September 2013

Publication date (Electronic): 09 March 2013

Volume: 1

Issue: 3-4

Pages: 109-123

Affiliations

^aDepartments of Radiology and Neurosurgery, and ^bNeuroendovascular Services, Columbia University/New York Presbyterian Hospital, New York, N.Y., USA

Author notes

*Dr. C.A. Bruno, Department of Neurological Surgery, Neurological Institute, 710 West 168 Street, New York, NY 10032 (USA), E-Mail [e-mail]

Article

Publisher ID: 346927 Pmcid ID: PMC4138962 Other ID: Intervent Neurol 2012;1:109-123

DOI: 10.1159/000346927

PMC ID: PMC4138962

PubMed ID: 25187772

SO-VID: 1edb5de4-055b-4674-b227-6d2f9ef58cf7

Copyright statement: © 2013 S. Karger AG, Basel

License:

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Page count

Figures: 5, Tables: 4, Pages: 15

Product

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Categories

Subject: Review