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Targeted endovascular treatment for ruptured brain arteriovenous malformations

  • Kun Hou
  • Kan Xu
  • Xuan Chen
  • Tiefeng Ji
  • Yunbao Guo
  • Jinlu YuEmail author
Review
First Online:
  • 35 Downloads

Abstract

Currently, endovascular treatment (EVT) is recommended for ruptured brain arteriovenous malformation (BAVM). When performing EVT for ruptured BAVM, curative complete embolization without complications is the ideal goal, but, more often than not, it is difficult, impossible, and dangerous. Therefore, EVT targeted toward ruptured focal weak structures plays a very important role. No previous study has comprehensively reviewed the use of targeted EVT for ruptured BAVMs. Therefore, the current paper reviews the available literature on this subject. In BAVM, the ruptured focal weak structures may include flow-related aneurysms, intranidal venous dilated structures, intranidal fistula, and venous varices or ectasia. These ruptured focal weak structures have direct and indirect imaging presentations. The indirect imaging presentations indicate various intracranial hemorrhages. In direct imaging presentations, digital subtraction angiography (DSA) has the highest degree resolution for showing ruptured focal weak structures. In addition, some magnetic resonance (MR) sequences can be useful to identify ruptured focal weak structures. Of all ruptured focal weak structures, flow-related aneurysms are considered the highest risk and require urgent occlusion. Other ruptured weak structures also need to undergo targeted EVT. After targeted EVT, a good prognosis can be obtained. Therefore, the use of targeted EVT for ruptured BAVM is promising.

Keywords

Ruptured brain arteriovenous malformation Targeted endovascular treatment Review 
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryThe First Hospital of Jilin UniversityChangchunChina
  2. 2.Department of RadiologyThe First Hospital of Jilin UniversityChangchunChina

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