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Updated: Jun 2, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Surgical treatment of patients with congenital vascular malformation-associated aneurysms
Insights
Aneurysms are a significant complication of congenital vascular malformations (CVM). Early treatment of CVM and regular screening for aneurysms are crucial for patient survival and preventing rupture.
Area of Science:
- Vascular Surgery
- Neurology
- Radiology
Background:
- Congenital vascular malformations (CVM) can lead to critical complications, including aneurysms.
- Extracranial CVM-associated aneurysms require careful clinical evaluation and management.
Observation:
- A review of 48 CVM patients from 1999-2008 identified aneurysms in 14 (29%).
- Aneurysms were classified by morphology (saccular, fusiform) and location relative to the CVM.
- Saccular aneurysms were more frequently ruptured or enlarging.
Findings:
- CVM subtypes included predominantly arteriovenous shunting defects, combined vascular defects, and mixed types.
- Surgical intervention was performed in six patients, with one instance each of recurrence and rupture post-operatively.
- The study highlights the prevalence and characteristics of aneurysms in CVM patients.
Implications:
- Aneurysm formation is a notable complication of CVM, necessitating proactive management.
- Timely treatment of CVM is essential to prevent emergent complications.
- Regular screening and appropriate management of aneurysms in CVM patients are indispensable for improved outcomes.
Objectives:
Aneurysms associated with congenital vascular malformation (CVM) comprise critical complication. We review our experience with extracranial CVM-associated aneurysms and attempt to clarify their clinical features.
Patients And Methods:
The prevalence, site, size and morphology of the accompanying aneurysms of 48 consecutive CVM patients, who were managed at our hospital from 1999 to 2008, were evaluated. After diagnosis or treatment, the patients were followed up, and the recurrence of aneurysms and patient survival were assessed.
Results:
CVM-associated aneurysms were found in 14 patients (29%). CVMs were classified according to the Hamburg classification. The patients were classified into groups as follows: four (31%), in the 'predominantly arteriovenous (AV) shunting defect type'; eight (47%), 'combined vascular defects + predominantly AV shunting defects type'; and two (11%), 'combined vascular defects type'. All aneurysms except one situated at the CVM were saccular, whereas nine were fusiform aneurysms; all the ruptured aneurysms and seven out of the nine enlarging aneurysms were saccular. Surgical treatment was performed 8 times in six patients. During the postoperative follow-up period, recurrence and an aneurysm rupture were encountered in one patient each.
Conclusion:
Aneurysm is not a rare complication of CVM. It is important to treat CVM before the emergency presents. In addition to the treatment for malformation, regular screening for and proper management of the aneurysms in CVM patients are indispensable.
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