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Interventional treatment of arterio-venous malformations = Interventionelle Behandlung von arteriovenösen Fehlbildungen

Yakes, W. ; Baumgartner, I.

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    Title
    • Interventional treatment of arterio-venous malformations
    Translated Title ()
    • Interventionelle Behandlung von arteriovenösen Fehlbildungen
    Author
    • Yakes, W.. Swedish Vascular Malformation Center, 501 E. Hampden Avenue, Suite 4600, 80113, Englewood, CO, USA
    • Baumgartner, I.. Division of Angiology, Swiss Cardiovascular Center, INSELSPITAL, University Hospital, 3000, Bern, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:325156
    Summary
    Background: Due to their hemodynamic effects and tendency to progress, the majority of congenital arterio-venous malformations (AVM) require treatment. AVM are classified according to clinical severity (Schobinger classification, stages I-V) and angiographic appearance (types I-IV). Treatment: Endovascular embolization is the treatment of choice. However, because complications such as necrosis and neuropathy occur in up to 15% of cases, treatment is challenging and is dependent on the angiographic appearance. Critical for treatment success is elimination of the so-called nidus, which is the location of the short circuit connection between the artery and the often extended aneurysm-like drainage vein. Embolization of only the feeding artery without the actual nidus or the incomplete elimination of drainage veins should be avoided. Absolute 96 % alcohol in addition to coiling of the nidus has been established as the most effective technique. Conclusion: Unlike other embolic agents, alcohol leads to a definitive destruction of the vessel wall. Recanalization and recurrence are excluded due to adequate elimination of the nidus.