Document Detail

Curing arteriovenous malformations using embolization.
MedLine Citation:
PMID:  25175438     Owner:  NLM     Status:  In-Data-Review    
Endovascular embolization is typically reserved as an adjuvant therapy in the management of cerebral arteriovenous malformations (AVMs), either for preoperative devascularization or preradiosurgical volume reduction. Curative embolization plays a limited role in AVM treatment but several studies have shown that it is possible, especially with later-generation liquid embolic agents. Given the complexity of AVM anatomy and the recent controversies over the role of any intervention in AVM management, it is critical that the cerebrovascular community better define the indications of each treatment modality to provide quality AVM management. In this review, the authors evaluate the role of curative AVM embolization. Important considerations in the feasibility of curative AVM embolization include whether it can be performed reliably and safely, and whether it is a durable cure. Studies over the past 20 years have begun to define the anatomical factors that are amenable to complete endovascular occlusion, including size, feeding artery anatomy, AVM morphology, and endovascular accessibility. More recent studies have shown that highly selected patients with AVMs can be treated with curative intent, leading to occlusion rates as high as 100% of such prospectively identified lesions with minimal morbidity. Advances in endovascular technology and techniques that support the efficacy and safety of curative embolization are discussed, as is the importance of superselective diagnostic angiography. Finally, the durability of curative embolization is analyzed. Overall, while still unproven, endovascular embolization has the potential to be a safe, effective, and durable curative treatment for select AVMs, broadening the armamentarium with which one can treat this disease.
Matthew B Potts; Daniel W Zumofen; Eytan Raz; Peter K Nelson; Howard A Riina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgical focus     Volume:  37     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2014 Sep 
Date Detail:
Created Date:  2014-09-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E19     Citation Subset:  IM    
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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