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13.11.2019 | Review

Targeted endovascular treatment for ruptured brain arteriovenous malformations

verfasst von: Kun Hou, Kan Xu, Xuan Chen, Tiefeng Ji, Yunbao Guo, Jinlu Yu

Erschienen in: Neurosurgical Review | Ausgabe 6/2020

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Abstract

Currently, endovascular treatment (EVT) is recommended for ruptured brain arteriovenous malformation (BAVM). When performing EVT for ruptured BAVM, curative complete embolization without complications is the ideal goal, but, more often than not, it is difficult, impossible, and dangerous. Therefore, EVT targeted toward ruptured focal weak structures plays a very important role. No previous study has comprehensively reviewed the use of targeted EVT for ruptured BAVMs. Therefore, the current paper reviews the available literature on this subject. In BAVM, the ruptured focal weak structures may include flow-related aneurysms, intranidal venous dilated structures, intranidal fistula, and venous varices or ectasia. These ruptured focal weak structures have direct and indirect imaging presentations. The indirect imaging presentations indicate various intracranial hemorrhages. In direct imaging presentations, digital subtraction angiography (DSA) has the highest degree resolution for showing ruptured focal weak structures. In addition, some magnetic resonance (MR) sequences can be useful to identify ruptured focal weak structures. Of all ruptured focal weak structures, flow-related aneurysms are considered the highest risk and require urgent occlusion. Other ruptured weak structures also need to undergo targeted EVT. After targeted EVT, a good prognosis can be obtained. Therefore, the use of targeted EVT for ruptured BAVM is promising.
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Metadaten
Titel
Targeted endovascular treatment for ruptured brain arteriovenous malformations
verfasst von
Kun Hou
Kan Xu
Xuan Chen
Tiefeng Ji
Yunbao Guo
Jinlu Yu
Publikationsdatum
13.11.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Neurosurgical Review / Ausgabe 6/2020
Print ISSN: 0344-5607
Elektronische ISSN: 1437-2320
DOI
https://doi.org/10.1007/s10143-019-01205-1

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