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Cerebral Arteriovenous Malformations: Endovascular Therapy Perspective

  • Felipe C. Albuquerque
  • David Fiorella
  • Cameron G. McDougall

Abstract

Arteriovenous malformations (AVMs) are highly complex vascular lesions that typically present in young patients (ages 20 to 40) with hemorrhage, seizures, headache, or focal neurologic deficits. The most common and compelling reason for treatment is the prevention of hemorrhage. Existing data indicate that only complete eradication of the lesion provides protection from future hemorrhage, and partial treatment is not helpful and may in fact increase the rate of future hemorrhage.

Keywords

Arteriovenous Malformation Stereotactic Radiosurgery Preoperative Embolization Gamma Knife Surgery Cerebral Arteriovenous Malformation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Berman MF, Sciacca RR, Pile-Spellman J, et al. The epidemiology of brain arteriovenous malformations. Neurosurgery 2000; 47:389–397.CrossRefPubMedGoogle Scholar
  2. 2.
    Itoyama Y, Uemura S, Ushio Y, et al. Natural course of unoperated arteriovenous malformations: study of 50 cases. J Neurosurg 1989; 71:805–809.CrossRefPubMedGoogle Scholar
  3. 3.
    Al-Shahi R, Warlow CP. Quality of the evidence for the management of cerebral arteriovenous malformations. Lancet 2002; 360:1022–1023.CrossRefPubMedGoogle Scholar
  4. 4.
    Crawford PM, West CR, Chadwick DW, Shaw MDM. Arteriovenous malformations of the brain. Natural history in unoperated patients. J Neurol Neurosurg Psychiatry 1986; 49:1–10.CrossRefPubMedGoogle Scholar
  5. 5.
    Mast H, Young WL, Koennecke HC, et al. Risk of spontaneous hemorrhage after diagnosis of cerebral arteriovenous malformation. Lancet 1997; 350:1065–1068.CrossRefPubMedGoogle Scholar
  6. 6.
    Graf CJ, Perrett GE, Torner JC. Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg 1983; 58:331–337.CrossRefPubMedGoogle Scholar
  7. 7.
    Jane JA, Kassell NF, Torner JC, et al. The natural history of aneurysms and arteriovenous malformations. J Neurosurg 1985; 62:321–323.CrossRefPubMedGoogle Scholar
  8. 8.
    Hamilton MG, Spetzler RF. The prospective application of a grading system for arteriovenous malformations. Neurosurgery 1994; 34:2–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Heros RC, Korosue K, Diebold PM. Surgical excision of cerebral arteriovenous malformations: late results. Neurosurgery 1990; 26(4):570–577.CrossRefPubMedGoogle Scholar
  10. 10.
    Lawton MT. Spetzler-Martin Grade III arteriovenous malformations: surgical results and a modification of the grading scale. Neurosurgery 2003; 52:740–748.CrossRefPubMedGoogle Scholar
  11. 11.
    Han PP, Ponce FA, Spetzler RF. Intention-to-treat analysis of Spetzler-Martin grade IV and V arteriovenous malformations: Natural history and treatment paradigm. J Neurosurg 2003; 98:3–7.CrossRefPubMedGoogle Scholar
  12. 12.
    Miyamota S, Hashimoto N, Nagata I, et al. Posttreatment sequelae of palliatively treated cerebral arteriovenous malformations. Neurosurgery 2004; 6:589–595.Google Scholar
  13. 13.
    Wikholm G, Lundqvist C, Svendsen P. The Göteborg cohort of embolized cerebral arteriovenous malformations: a 6-year follow-up. Neurosurgery 2001; 9:799–806.CrossRefGoogle Scholar
  14. 14.
    Jafar JJ, David AJ, Berenstein A, et al. The effect of embolization with n-butylcyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg 1993; 78:60–69.CrossRefPubMedGoogle Scholar
  15. 15.
    DeMerritt JS, Pile-Spellman J, Moohan MN, et al. Outcome analysis of preoperative embolization with n-butylcyanoacrylate in cerebral arteriovenous malformations. Am J Neuroradiol AJNR 1995; 16:1801–1807.Google Scholar
  16. 16.
    Kim EJ, Halim AX, Dowd CF, et al. The relationship of coexisting extra-nidal aneurysms to intracranial hemorrhage in patients harboring brain arteriovenous malformations. Neurosurgery 2004; 54(6):1349–1358.CrossRefPubMedGoogle Scholar
  17. 17.
    Lasjunias P, Piske R, Terbrugge K, et al. Cerebral arteriovenous malformations and associated cerebral aneurysms. Acta Neurochir 1988; 91:29–36.CrossRefGoogle Scholar
  18. 18.
    Marks MP, Lane B, Steinberg G, Chang PJ. Hemorrhage in intracerebral arteriovenous malformations. Radiology 1990; 176:807–813.PubMedGoogle Scholar
  19. 19.
    Redekop G, TerBrugge K, Montanera W, Willinsky R. Arterial aneurysms associated with cerebral arteriovenous malformations. J Neurosurg 1998; 89:539–546.CrossRefPubMedGoogle Scholar
  20. 20.
    Brown RD, Wiebers DO, Forbes GS. Unruptured intracranial aneurysms and arteriovenous malformations: Frequency of intracranial hemorrhage and relationship of lesions. J Neurosurgery 1990; 73:859–863.CrossRefGoogle Scholar
  21. 21.
    Kwon Y, Jeon SR, Kim JH, et al. Analysis of the causes of treatment failure in gamma knife radiosurgery for intracranial arteriovenous malformations. J Neurosurg 2000; 93(Suppl 3):104–106.PubMedGoogle Scholar
  22. 22.
    Lundsford LD, Kondziolka D, Flickinger JI, et al. Stereotactic radiosurgery for arteriovenous malformations of the brain. J Neurosurg 1991; 75:512.CrossRefGoogle Scholar
  23. 23.
    Steiner L, Lindquist C, Adler JR, et al. Clinical outcome of radiosurgery for cerebral arteriovenous malformations. J Neurosurg 1992; 77:1.CrossRefPubMedGoogle Scholar
  24. 24.
    Gobin YP, Laurent A, Merienne L, et al. Treatment of brain arteriovenous malformations by embolization and radiosurgery. J Neurosurg 1996; 85:19–28.CrossRefPubMedGoogle Scholar
  25. 25.
    Henkes H, Nahser HC, Berg-Dammer E, et al. Endovascular therapy of brain AVMs prior to radiosurgery. Neurol Res 1998; 20(6):479–492.PubMedGoogle Scholar
  26. 26.
    Maruyama K, Shin M, Tago M, et al. Gamma knife surgery for arteriovenous malformations involving the corpus callosum. J Neurosurg 2005; 102:49–52.CrossRefPubMedGoogle Scholar
  27. 27.
    Andrade-Souza YM, Zadeh G, Scora D, et al. Radiosurgery for basal ganglia, internal capsule, and thalamus arteriovenous malformation: clinical outcome. Neurosurgery 2005; 56:56–64.CrossRefPubMedGoogle Scholar
  28. 28.
    Pollock BE, Gorman DA, Brown PD. Radiosurgery for arteriovenous malformations of the basal ganglia, thalamus, and brainstem. J Neurosurg 2004; 100:210–214.CrossRefPubMedGoogle Scholar
  29. 29.
    Maruyama K, Kondziolka D, Niranjan A, et al. Stereotactic radiosurgery for brainstem arteriovenous malformations: factors affecting outcome. J Neurosurg 2004; 100:407–413.CrossRefPubMedGoogle Scholar
  30. 30.
    Shin M, Maruyama K, Kurita H, et al. Analysis of nidus obliteration rates after gamma knife surgery for arteriovenous malformations bases on long-term follow-up data: the University of Tokyo experience. J Neurosurg 2004; 101:18–24.CrossRefPubMedGoogle Scholar
  31. 31.
    Szeifert GT, Major O, Kemeny AA. Ultrastructural changes in arteriovenous malformation after gamma knife surgery: an electron microscopic study. J Neurosurg 2005; 102:289–292.CrossRefPubMedGoogle Scholar
  32. 32.
    Schaubles B, Cascino GD, Pollack BE, et al. Seizure outcomes after stereotactic radiosurgery for cerebral arteriovenous malformations. Neurology 2004, 63(4):683–687.Google Scholar
  33. 33.
    Izawa M, Hayashi M, Chernov M, et al. Long-term complications after gamma knife surgery for arteriovenous malforamtions. J Neurosurg 2005; 102:34–37.CrossRefPubMedGoogle Scholar
  34. 34.
    Nataf F, Ghossoub M, Schlienger M, et al. Bleeding after radiosurgery for cerebral arteriovenous malformations. Neurosurgery 2004; 55:298–306.CrossRefPubMedGoogle Scholar
  35. 35.
    Zipfel GJ, Bradshaw P, Bova FJ, Friedman WA. Do the morphological characteristics of arteriovenous malformations affect the results of radiosurgery? J Neurosurgery 2004; 101:393–401.CrossRefGoogle Scholar
  36. 36.
    Viñuela F, Duckwiler G, Guglielmi G. Contribution of interventional neuroradiology in the therapeutic management of brain arteriovenous malformations. J Stroke Cerebrovasc Dis 1997; 4:268–271.CrossRefGoogle Scholar
  37. 37.
    Wilkholm G, Lundqvist C, Svendsen P. Embolization of cerebral arteriovenous malformations: part I. Technique, morphology and complications. Neurosurgery 1996; 3:448–459.CrossRefGoogle Scholar
  38. 38.
    Fournier D, TerBrugge KG, Willinsky R, et al. Endovascular treatment of intracerebral arteriovenous malformations. J Neurosurg 1991; 75:228–233.CrossRefPubMedGoogle Scholar
  39. 39.
    Yu SCH, Chan MSY, Lam JMK, et al. Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: initial success and rate of permanent cure. AJNR 2004; 25:1139–1143.PubMedGoogle Scholar
  40. 40.
    Valavanis A, Christoforidis G. Endovascular management of cerebral arteriovenous malformations. Neurointerventionist 1999; 1:34–40.Google Scholar
  41. 41.
    Batjer HH, Devous MD Sr, Seibert GB, et al. Intracranial arteriovenous malformation: relationships between clinical and radiographic factors and ipsilateral steal severity. Neurosurgery 1988; 23:322–328.CrossRefPubMedGoogle Scholar
  42. 42.
    Marks MP, Lane B, Steinberg G, et al. Vascular characteristics of intracerebral arteriovenous malformations in patients with clinical steal. AJNR 1991; 12:489–496.PubMedGoogle Scholar
  43. 43.
    Kusske JA, Kelly WA. Embolization and reduction of the “steal” syndrome in cerebral arteriovenous malformations. J Neurosurg 1974; 40:313–321.CrossRefPubMedGoogle Scholar
  44. 44.
    Luessenhop AJ, Mujica PH. Embolization of segments of the circle of Willis and adjacent branches for management of certain inoperable cerebral arteriovenous malformations. J Neurosurg 1981; 54:573–582.CrossRefPubMedGoogle Scholar
  45. 45.
    Fox AJ, Girvin JP, Vinuela F, Drake CG. Rolandic arteriovenous malformations: improvement in limb function by IBC embolization. AJNR 1985; 6(4):575–582.PubMedGoogle Scholar
  46. 46.
    Mast H, Mohr JP. Osipov A, et al. “Steal” is an unestablished mechanism for the clinical presentation of cerebral arteriovenous malformations. Stroke 1995; 26:1215–1220PubMedGoogle Scholar
  47. 47.
    Taylor CL, Dutton K, Rappard G, et al. Complications of preoperative embolization of cerebral arteriovenous malformations. J Neurosurg 2004; 100(5):810–812.CrossRefPubMedGoogle Scholar
  48. 48.
    Debrun GM, Aletich V, Ausman JI, et al. Embolization of nidus of brain arteriovenous malformations with n-butyl cyanoacrylate. Neurosurgery 1997; 40:112–121.CrossRefPubMedGoogle Scholar
  49. 49.
    Viñuela F, Dion JE, Duckwiler GR, et al. Combined endovascular embolization and surgery in the management of cerebral arteriovenous malformations. J Neurosurg 1991; 75:856–864.CrossRefPubMedGoogle Scholar
  50. 50.
    Wallace RC, Flom RA, Khayata MH, et al. The safety and effectiveness of brain arteriovenous malformation embolization using acrylic and particles. Neurosurgery 1995; 37:606–618.CrossRefPubMedGoogle Scholar
  51. 51.
    Jahan R, Murayama Y, Gobin YP, et al. Embolization of arteriovenous malformations with Onyx: clinicopathological experience in 23 patients. Neurosurgery 2001; 48(5):984–995.CrossRefPubMedGoogle Scholar
  52. 52.
    Hartmann A, Pile-Spellman J, Stapf C, et al. Risk of endovascular treatment of brain arteriovenous malformations. Stroke 2002; 33:1816–1820.CrossRefPubMedGoogle Scholar
  53. 53.
    Frizzel RT, Fisher WS. Cure, morbidity, and mortality associated with embolization of brain arteriovenous malformations: a review of 1246 patients in 32 series over a 35 year period. Neurosurgery 1995; 37:1031–1040.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Felipe C. Albuquerque
    • 1
  • David Fiorella
    • 2
  • Cameron G. McDougall
    • 3
  1. 1.Barrow Neurological InstituteSt. Joseph’s Hospital and Medical CenterPhoenixUSA
  2. 2.Department of Neuroradiology and NeurosurgeryCleveland Clinic FoundationClevelandUSA
  3. 3.Barrow Neurological Institute—NeurosurgerySt. Joseph’s Hospital and Medical CenterPhoenixUSA

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