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Embolization of Cerebral Arteriovenous Malformations

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PanVascular Medicine

Abstract

Effective treatment of cerebral arteriovenous malformations (AVMs) requires a multidisciplinary approach that combines microsurgical resection, endovascular embolization, and radiosurgery. Embolization is most commonly used to reduce the arterial supply before surgery or radiosurgery. Additional indications include an attempt to achieve cure through complete AVM obliteration, targeted treatment to eliminate high-risk features, and subtotal occlusion to palliate symptoms caused by an otherwise incurable AVM. In all cases, the risks and benefits of treatment must be weighed carefully when formulating a treatment strategy. Ultimately, for optimal management of cerebral AVMs, treating centers should have access to physicians experienced in open cerebrovascular surgery, endovascular embolization, and radiosurgery.

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Abbreviations

Distal Access Catheter:

Intermediate diameter catheter used to create a tri-axial system between the guide catheter/sheath and microcatheter. Frequently used in multiple-pedicle embolization procedures to minimize the need to re-catheterize the proximal vessel.

EVOH:

Ethylene vinyl alcohol copolymer, trade name Onyx, a cohesive liquid embolisate used for embolization of cerebral arteriovenous malformations.

DMSO:

Dimethyl sulfoxide, solvent in which EVOH is suspended and delivered.

nBCA:

n-Butyl cyanoacrylate, trade name Trufill, otherwise known as glue. Adhesive liquid embolic agent used in the embolization of arteriovenous malformations.

AVM:

Arteriovenous malformation

DAC:

Distal access catheter

DMSO:

Dimethyl sulfoxide

DSA:

Digital subtraction angiography

EVOH:

Ethylene vinyl alcohol copolymer

nBCA:

n-Butyl cyanoacrylate

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Authors and Affiliations

  1. Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 200 Lothrop Street, Suite B-400, Pittsburgh, PA, 15213, USA

    Andrew F. Ducruet

  2. Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Charlottesville, VA, 22901, 800212, USA

    R. Webster Crowley

  3. Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, 350 W Thomas Rd, Phoenix, AZ, 85013, USA

    Cameron G. McDougall & Felipe C. Albuquerque

Authors
  1. Andrew F. Ducruet
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  2. R. Webster Crowley
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  3. Cameron G. McDougall
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  4. Felipe C. Albuquerque
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Corresponding author

Correspondence to Felipe C. Albuquerque .

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Editors and Affiliations

  1. Division of Cardiovascular Disease Department of Internal Medicine, Health Care Center Bitterfeld, Bitterfeld-Wolfen, Germany

    Peter Lanzer

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Ducruet, A.F., Crowley, R.W., McDougall, C.G., Albuquerque, F.C. (2015). Embolization of Cerebral Arteriovenous Malformations. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_94

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  • DOI: https://doi.org/10.1007/978-3-642-37078-6_94

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