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Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities
Journal article   Peer reviewed

Hemodynamics Associated With Intracerebral Arteriovenous Malformations: The Effects of Treatment Modalities

Vernard S Fennell, Nikolay L Martirosyan, Gursant S Atwal, M Yashar S Kalani, Francisco A Ponce, G Michael Lemole, Jr, Travis M Dumont and Robert F Spetzler
Neurosurgery, Vol.83(4), pp.611-621
10/01/2018
PMID: 29267943

Abstract

Combined Modality Therapy - methods Embolization, Therapeutic - methods Endovascular Procedures - methods Female Hemodynamics - physiology Humans Intracranial Arteriovenous Malformations - physiopathology Intracranial Arteriovenous Malformations - therapy Male Neurosurgical Procedures - methods
The understanding of the physiology of cerebral arteriovenous malformations (AVMs) continues to expand. Knowledge of the hemodynamics of blood flow associated with AVMs is also progressing as imaging and treatment modalities advance. The authors present a comprehensive literature review that reveals the physical hemodynamics of AVMs, and the effect that various treatment modalities have on AVM hemodynamics and the surrounding cortex and vasculature. The authors discuss feeding arteries, flow through the nidus, venous outflow, and the relative effects of radiosurgical monotherapy, endovascular embolization alone, and combined microsurgical treatments. The hemodynamics associated with intracranial AVMs is complex and likely changes over time with changes in the physical morphology and angioarchitecture of the lesions. Hemodynamic change may be even more of a factor as it pertains to the vast array of single and multimodal treatment options available. An understanding of AVM hemodynamics associated with differing treatment modalities can affect treatment strategies and should be considered for optimal clinical outcomes.

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