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Bendok, Bernard R. et al.: 2025 Hemorrhagic and Ischemic Stroke DOI: 10.1055/b-0044-205940
Section IV Neurointerventional Approaches

39 Endovascular Management of Arteriovenous Malformations

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Editors: Bendok, Bernard R.; Batjer, H. Hunt

Authors: Abi-Aad, Karl; Abuelem, Tarek; Açiş, Onur; Agnoletto, Guilherme J.; El Ahmadieh, Tarek; Albuquerque, Felipe C.; Amenta, Peter S.; Amoss, James; Aoun, Salah G.; Arthur, Adam S.; Awad, Issam A.; Ban, Vin Shen; Barrow, Daniel L.; Bebawy, John F.; Biller, José; Binning, Mandy J.; Blech, Benzion; Bonney, Phillip A.; Brasiliense, Leonardo B.C.; Carlin, Rachel E.; Carrión-Penagos, Julián; Chong, Brian W.; Christel, Lynda M.; Church, Ephraim W.; Connolly, E. Sander; Connor, Michelle; Dalfino, John C.; Demaerschalk, Bart M.; Dumitrascu, Oana M.; Entezami, Pouya; Felbaum, Daniel; Freeman, W. David; Garcia, Jose Omar; Goyal, Nitin; Granja, Manuel F.; Hanel, Ricardo A.; Heiferman, Daniel M.; Hemphill, J. Claude; Hess, Ryan; Howard, Brian M.; Hudson, Miles; Ingall, Timothy J.; Inoa, Violiza; Jabbour, Pascal M.; Jacob, Sneha; Johnson, Mark D.; Kalen, Brian; Kicielinski, Kimberly P.; Koester, Stefan W.; Koht, Antoun; Kondziolka, Douglas; Krishna, Chandan; Kronenburg, Annick; Kumar, Gyanendra; Langer, David; Levy, Elad I.; Mack, William J.; Merrill, Sarah; Meyer, Fredric B.; Monteiro, André; Montaño, Arturo; El Naamani, Kareem; Nossek, Erez; O’Carroll, Cumara B.; Ogilvy, Christopher S.; Ogunsola, Oludotun; Ottenhoff, Lauren; Oushy, Soliman; Patel, Bhavesh; Patra, Devi P.; Peacock, Sarah; Pena, Austin; Pines, Andrew; Polster, Sean P.; Rahme, Rudy J.; Rebeiz, Tania; Riina, Howard; Rinaldo, Lorenzo; Sattur, Mithun G.; Sen, Ayan; Siegel, Jason; Sim, Justin L.; Simon, Scott D.; Solomon, Robert A.; Spetzler, Robert; Sweid, Ahmad; Syal, Arjun; Tomlinson, Amanda; Turcotte, Evelyn L.; Turkmani, Ali H.; Vakharia, Kunal; Vanderhye, Vanesa K.; Veznedaroglu, Erol; Walia, Parampreet Singh; Waqas, Muhammad; Welch, Babu G.; Welz, Matthew E.; White, Jonathan A.; Winter, JoDee; Zaatar, Muriel T.; Zeeni, Carine

Title: Hemorrhagic and Ischemic Stroke

Subtitle: Medical, Imaging, Surgical, and Interventional Approaches

Print ISBN: 9781684200436; Online ISBN: 9781684203819; Book DOI: 10.1055/b000000291

2. Edition © 2025. Thieme. All rights reserved.
Thieme Medical Publishers, Inc., New York

Subjects: Neurosurgery

Thieme Clinical Collections (English Language)



Rudy J. Rahme, Devi P. Patra, Matthew E. Welz, Karl Abi-Aad, Arjun Syal, Evelyn L. Turcotte, and Bernard R. Bendok

Abstract

Arteriovenous malformations (AVMs) are highly complex vascular lesions formed by direct connections between arteries and veins with no intervening capillary bed. When treatment is being considered, a thorough diagnostic cerebral angiogram is a key first step that allows for an optimal understanding of the angioarchitecture, which is necessary to formulate a treatment plan. Super-selective angiography can be helpful to understand a complex nidus and to judge the safety and potential for embolization whether it be for the nidus, associated aneurysms, or draining veins. Embolization can have a large number of therapeutic objectives focused on the AVM, surrounding brain tissue, and associated aneurysms. Endovascular approaches can be used as targeted therapy for high-risk features, or as an adjunct to microsurgery and radiosurgery. Embolization can also be used as a stand-alone treatment with an intent to cure or palliation for select AVMs. In this chapter, we review the natural history of AVMs, and the indications and techniques of endovascular embolization.

Key words

arteriovenous malformation - embolization - endovascular treatment - microcatheter