Embolization before stereotactic radiosurgery for the treatment of brain arteriovenous malformations

Embolization is commonly used for the treatment of brain arteriovenous malformations (AVMs) prior to stereotactic radiosurgery (SRS). Due to mixed outcomes, however, its use remains controversial. This article is a review of recent studies assessing the efficacy of pre-radiosurgical embolization for brain AVMs. Articles published between 1990 and 2017 on the subject of pre-radiosurgical AVM embolization were retrieved from PubMed. A literature review was performed on the selected studies to compare obliteration, hemorrhage, and complication rates from groups treated with embolization prior to radiosurgery to those treated without embolization. Overall, the studies reviewed demonstrate mixed results on the efficacy of pre-radiosurgical AVM embolization. For large, complex AVMs, embolization prior to radiosurgery may have a role in carefully selected patients performed by experienced practitioners.