Overview
Summary
Embolisation is one of the three treatments of a brain arteriovenous malformation (AVM), ruptured or unruptured, and is used on its own or combined with microsurgery or stereotactic radiosurgery (SRS). Planning starts with what the embolisation is for and whether the lesion could be cured by embolisation alone, which depends on its angioarchitecture. Liquid embolic agents are then injected into the nidus through a feeding artery or, in selected small lesions, retrogradely through the draining vein. Haemorrhage is the main complication of the procedure. Follow-up covers how cure is confirmed and how long the nidus is watched for recurrence.
Takeaways
- 1
Embolise only within a multidisciplinary plan aiming at obliteration, and state the goal of each session.
- 2
Attempt cure by embolisation alone mainly in small, compact, low-grade lesions with few feeders and draining veins.
- 3
Declare cure only on delayed catheter angiography, never on the final run, and keep imaging afterwards.
Start here
- Endovascular treatment in the multimodality management of brain arteriovenous malformations: report of the Society of NeuroInterventional Surgery Standards and Guidelines CommitteeDe Leacy 2022 · J Neurointerv Surg
- Primary Embolization of Cerebral Arteriovenous Malformations With Intention to Cure: A Systematic Review of Literature and Meta-AnalysisDabhi 2024 · Neurosurgery · pivotal
- Glue, Onyx, Squid or PHIL? Liquid embolic agents for the embolization of cerebral arteriovenous malformations and dural arteriovenous fistulasVollherbst 2021 · Clin Neuroradiol
- Transvenous Approach for the Treatment of Cerebral Arteriovenous Malformations: A Randomized Comparison With Transarterial EmbolizationRaymond 2025 · Stroke · pivotal
- Periprocedural intracranial hemorrhage after embolization of cerebral arteriovenous malformations: a meta-analysisSubat 2019 · J Neurosurg
- Long-term complications and outcomes of therapeutic embolization of cerebral arteriovenous malformations: a systematic reviewLúcio VBDS 2024 · Sao Paulo Med J
Brain AVM embolisation
Brain arteriovenous malformationsChapter 3 of 3
Summary
Embolisation is one of the three treatments of a brain arteriovenous malformation (AVM), ruptured or unruptured, and is used on its own or combined with microsurgery or stereotactic radiosurgery (SRS). Planning starts with what the embolisation is for and whether the lesion could be cured by embolisation alone, which depends on its angioarchitecture. Liquid embolic agents are then injected into the nidus through a feeding artery or, in selected small lesions, retrogradely through the draining vein. Haemorrhage is the main complication of the procedure. Follow-up covers how cure is confirmed and how long the nidus is watched for recurrence.
Takeaways
- 1
Embolise only within a multidisciplinary plan aiming at obliteration, and state the goal of each session.
- 2
Attempt cure by embolisation alone mainly in small, compact, low-grade lesions with few feeders and draining veins.
- 3
Declare cure only on delayed catheter angiography, never on the final run, and keep imaging afterwards.
Start here
- Endovascular treatment in the multimodality management of brain arteriovenous malformations: report of the Society of NeuroInterventional Surgery Standards and Guidelines CommitteeDe Leacy 2022 · J Neurointerv Surg
- Primary Embolization of Cerebral Arteriovenous Malformations With Intention to Cure: A Systematic Review of Literature and Meta-AnalysisDabhi 2024 · Neurosurgery · pivotal
- Glue, Onyx, Squid or PHIL? Liquid embolic agents for the embolization of cerebral arteriovenous malformations and dural arteriovenous fistulasVollherbst 2021 · Clin Neuroradiol
- Transvenous Approach for the Treatment of Cerebral Arteriovenous Malformations: A Randomized Comparison With Transarterial EmbolizationRaymond 2025 · Stroke · pivotal
- Periprocedural intracranial hemorrhage after embolization of cerebral arteriovenous malformations: a meta-analysisSubat 2019 · J Neurosurg
- Long-term complications and outcomes of therapeutic embolization of cerebral arteriovenous malformations: a systematic reviewLúcio VBDS 2024 · Sao Paulo Med J