Predicament and Challenges in the Treatment of Intracranial Arterio-Venous Malformations

Chao Gao, Yanbing Song, Bing Leng

Article ID: 90
Vol 1, Issue 1, 2017

VIEWS - 8319 (Abstract)

Abstract


Arterio-venous malformation (AVM) is the most common clinical disease caused by intracranial vascular dysplasia. AVM has particular importance in the clinical setting and is difficult to treat because of its high disability and case fatality rate, as well as the uncertainty of its natural course and complex blood flow structure. The treatments for arterio-venous malformations mainly include conservative treatment, surgical resection, endovascular interventional treatment and stereotactic radiotherapy. It is difficult to discern the so-called arterio-venous malformation treatment norms within the clinical setting, as there are many different treatment combinations, different arterio-venous malformation classifications, different clinical manifestations and different high risk factors. Therefore, we are faced with a challenge regarding the treatment of intracranial arterio-venous malformations in clinical practice.

Keywords


intracranial treatment; arteriovenous malformations

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References


van Beijnum J, van der Worp HB, Buis DR, et al. Treatment of brain arteriovenous malformations: A systematic review and meta-analysis. JAMA 2011; 306(18): 2011–2019. https://doi.org/10.1001/jama.2011.1632 Gross BA, Du R. Natural history of cerebral arteriovenous malformations: A meta-analysis. J Neurosurg 2013; 118(2): 437–443. https://doi.org/10.3171/2012.10.JNS121280 Mohr JP, Parides MK, Stapf C, et al. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): A multicenter, non-blinded, randomised trial. Lancet 2014; 383(9917): 614–621. https://doi.org/10.1016/S0140-6736(13)62302-8 Bai J, Dou C, Wang Y, et al. (Mandarin) [Correlation of angioarchitectural factors with cerebral arteriovenous malformation hemorrhage]. Natl Med J China 2012; 92(31): 2202–2204. Josephson CB, Bhattacharya JJ, Counsell CE, et al. Seizure risk with AVM treatment or conservative management: Prospective, population-based study. Neurology 2012; 79(6): 500–507. https://doi.org/10.1212/WNL.0b013e3182635696 Elhammady MS, Heros RC. Management of incidental cerebral AVMs in the post-ARUBA era. J Neurosurg 2014; 121(5): 1011–1014. https://doi.org/10.3171/2014.3.JNS14135 Cockroft KM, Jayaraman MV, Amin-Hanjani S, et al. A perfect storm: How a randomized trial of unruptured brain arteriovenous malformations’ (ARUBA’s) trial design challenges notions of external validity. Stroke 2012; 43(7):1979¬–1981. https://doi.org/10.1161/STROKEAHA.112.652032 Day AL, Dannenbaum M, Jung S. A randomized trial of unruptured brain arteriovenous malformations trial: An editorial review. Stroke 2014; 45(10): 3147–3148. https://doi.org/10.1161/STROKEAHA.114.004614 Nerva JD, Mantovani A, Barber J, et al. Treatment outcomes of unruptured arteriovenous malformations with a subgroup analysis of ARUBA (A Randomized Trial of Unruptured Brain Arteriovenous Malformations)-eligible patients. Neurosurgery 2015; 76(5): 563–570. https://doi.org/10.1227/NEU.0000000000000663 Al-Shahi R, Bhattacharya JJ, Currie DG, et al. Scottish Intracranial Vascular Malformation Study (SIVMS): Evaluation of methods, ICD-10 coding, and potential sources of bias in a prospective, population-based cohort. Stroke 2003; 34(5): 1156–1162. https://doi.org/10.1161/01.STR.0000069012.23858.69 Korja M, Bervini D, Assaad N, et al. Role of surgery in the management of brain arteriovenous malformations: Prospective cohort study. Stroke 2014; 45(12): 3549–3555. https://doi.org/10.1161/STROKEAHA.114.007206 Zhao J, Yu T, Wang S, et al. Surgical treatment of giant intracranial arteriovenous malformations. Neurosurgery 2010; 67(5): 1359–1370. https://doi.org/10.1227/NEU.0b013e3181eda216 Bervini D, Morgan MK, Ritson EA, et al. Surgery for unruptured arteriovenous malformations of the brain is better than conservative management for selected cases: A prospective cohort study. J Neurosurg 2014; 121(4): 878–890. https://doi.org/10.3171/2014.7.JNS132691 Hyun SJ, Kong DS, Lee JI, et al. Cerebral arteriovenous malformations and seizures: Differential impact on the time to seizure-free state according to the treatment modalities. Acta Neurochir (Wien) 2012; 154(6): 1003–1010. https://doi.org/10.1007/s00701-012-1339-8 von der Brelie C, Simon M, Esche J, et al. Seizure outcomes in patients with surgically treated cerebral arteriovenous malformations. Neurosurgery 2015; 77(5): 762¬–768. https://doi.org/10.1227/NEU.0000000000000919 Liu XJ, Wang S, Zhao YL, et al. Risk of cerebral arteriovenous malformation rupture during pregnancy and puerperium. Neurology 2014; 82(20): 1798–1803. https://doi.org/10.1212/WNL.0000000000000436 Chen W, Choi EJ, McDougall CM, et al. Brain arteriovenous malformation modeling, pathogenesis, and novel therapeutic targets. Transl Stroke Res 2014; 5(3): 316–329. https://doi.org/10.1007/s12975-014-0343-0 Ding D, Starke RM, Liu KC, et al. Cortical plasticity in patients with cerebral arteriovenous malformations. J Clin Neurosci 2015; 22(12): 1857–1861. https://doi.org/10.1016/j.jocn.2015.06.014 Bose R, Agrawal D, Singh M, et al. Draining vein shielding in intracranial arteriovenous malformations during gamma-knife: A new way of preventing post gamma-knife edema and hemorrhage. Neurosurgery 2015; 76(5): 623–632. https://doi.org/10.1227/NEU.0000000000000660 Yen CP, Sheehan JP, Schwyzer L, et al. Hemorrhage risk of cerebral arteriovenous malformations before and during the latency period after GAMMA knife radiosurgery. Stroke 2011; 42(6): 1691–1696. https://doi.org/10.1161/STROKEAHA.110.602706 Parkhutik V, Lago A, Tembl JI, et al. Postradiosurgery hemorrhage rates of arteriovenous malformations of the brain: Influencing factors and evolution with time. Stroke 2012; 43(5): 1247–1252. https://doi.org/10.1161/STROKEAHA.111.635789 Spiotta AM, James RF, Lowe SR, et al. Balloon-augmented Onyx embolization of cerebral arteriovenous malformations using a dual-lumen balloon: A multicenter experience. J Neurointerv Surg 2015; 7(10): 721–727. https://doi.org/10.1136/neurintsurg-2014-011285 Choudhri O, Ivan ME, Lawton MT. Transvenous approach to intracranial arteriovenous malformations: Challenging the axioms of arteriovenous malformation therapy? Neurosurgery 2015; 77(4): 644–651. https://doi.org/10.1227/NEU.0000000000000869 Ansari SA, Schnell S, Carroll T, et al. Intracranial 4D flow MRI: Toward individualized assessment of arteriovenous malformation hemodynamics and treatment-induced changes. AJNR Am J Neuroradiol 2013; 34(10): 1922–1928. https://doi.org/10.3174/ajnr.A3537 Wang Xin, Wang Enmin, Mei Guanghai, et al. (Mandarin) [Cyberknife radiosurgery for cerebral arteriovenous malformations: Outlining of the radiosurgical target and obliteration]. Natl Med J China 2014; 94(37): 2902–2906.



DOI: https://doi.org/10.63018/nc.v1i1.90

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