Nonsurgical Treatment for AVMs

Abstract

The treatment of choice of small symptomatic cerebral arteriovenous malformations (AVMs) in noneloquent regions is neurosurgical resection. In selected regions (deep structures, eloquent areas), the morbidity and mortality associated with surgical resection may exceed the risk from the disease itself. In selected patients, transvascular embolization may be of benefit in alleviating the symptoms or reducing the risks of the disease. Decisions as to the timing and type of treatment are complex and should by made by a team of neurologists, neurosurgeons, radiologists, and radiotherapists. Relatively few patients at our institution are treated by embolization alone; rather a combination of preoperative, intraoperative, and preradiation embolizations are far more common. A few of the more common indications for embolization are delineated below.