Semin intervent Radiol 2017; 34(03): 258-271
DOI: 10.1055/s-0037-1604299
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

New Treatment Approaches to Arteriovenous Malformations

Patrick Gilbert1, Josée Dubois2, Marie France Giroux1, Gilles Soulez1
  • 1Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, Quebec, Canada
  • 2Department of Radiology, Centre Hospitalier Universitaire Ste Justine, Université de Montréal, Montreal, Quebec, Canada
Further Information

Publication History

Publication Date:
11 September 2017 (online)

Abstract

Arteriovenous malformations (AVMs) are high-flow vascular anomalies that have demonstrated a very high recurrence rate after endovascular treatment, surgical treatment, or a combination of both. Surgical treatments have shown good response when they are small and well localized but a poor response when diffuse. A better understanding of the nature of the lesion has led to a better response rate and a safer treatment for these patients. This has been accomplished through a detailed understanding of the angioarchitecture of the lesion, enabling a tailored approach in reaching and targeting the nidus of the AVM with different liquid embolic agents, more specifically ethanol. Flow reduction techniques help in exposing the nidus to sclerosant agents. A clinical classification, the Schobinger classification, will help determine the appropriate time to start or to pursue therapy.