Endovascular advances for brain arteriovenous malformations

Document Type

Article

Abstract

Arteriovenous malformations (AVMs) of the brain represent unique challenges for treating physicians. Although these lesions have traditionally been treated with surgical resection alone, advancements in endovascular and radiosurgical therapies have greatly expanded the treatment options for patients harboring brain AVMs. Perhaps no subspecialty within neurosurgery has seen as many advancements over a relatively short period of time as the endovascular field. A number of these endovascular innovations have been designed primarily for cerebral AVMs, and even those advancements that are not particular to AVMs have resulted in substantial changes to the way cerebral AVMs are treated. These advancements have enabled the embolization of cerebral AVMs to be performed either as a stand-alone treatment, or in conjunction with surgery or radiosurgery. Perhaps nothing has impacted the treatment of brain AVMs as substantially as the development of liquid embolics, most notably Onyx and n-butyl cyanoacrylate. However, of near-equal impact has been the innovations seen in the catheters that help deliver the liquid embolics to the AVMs. These developments include flow-directed catheters, balloon-tipped catheters, detachable-tipped catheters, and distal access catheters. This article aims to review some of the more substantial advancements in the endovascular treatment of brain AVMs and to discuss the literature surrounding the expanding indications for endovascular treatment of these lesions.

Medical Subject Headings

Brain (blood supply, surgery); Cerebral Angiography; Embolization, Therapeutic (methods); Endovascular Procedures; Humans; Intracranial Arteriovenous Malformations (surgery); Neurosurgical Procedures

Publication Date

2-1-2014

Publication Title

Neurosurgery

E-ISSN

1524-4040

Volume

74 Suppl 1

First Page

S74

Last Page

82

PubMed ID

24402496

Digital Object Identifier (DOI)

10.1227/NEU.0000000000000176

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