Abstract
Over the past 40 years, stereotactic radiosurgery (SRS) has become an increasingly attractive option to both patients and physicians in the treatment of AVMs due to its high success rates and low risks. SRS already has a well-defined role in the treatment of small- to medium-sized AVMs. Advances in techniques and methods have improved the application of SRS in the management of larger AVMs and AVMs in eloquent locations, for which management has traditionally been challenging. These advances include radiation dosing, target optimization, utilization of radiosensitizers and radioprotectors, and use of adjunctive therapies such as endovascular embolization. Improvements in our overall understanding of AVM pathophysiology, biological properties, and natural history have further prompted the investigation of SRS adjuncts such as targeted pharmacological therapies and thermal modulation. SRS plays an important role in the treatment of certain AVMs, especially in those previously considered inoperable. Its role in AVM management will continue to expand and improve the outcome of these complex cerebrovascular lesions.. © 2024 Elsevier Inc. All rights reserved.