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Gilles Soulez1, Patrick Gilbert Md Frcpc2, Marie-France Giroux Md Frcpc2

  • 1Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Québec, Canada; Department of Radiology, Radiation-Oncology and Nuclear Medicine, Université de Montréal, Montreal, Québec, Canada; Institute of Biomedical engineering, Université de Montréal, Montréal, Québec, Canada; Laboratory of Clinical Imaging Processing, Centre hospitalier de l'Université de Montréal (CHUM) Research Center (CRCHUM), Montréal, Québec, Canada.

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Summary

Arteriovenous malformations (AVMs) are congenital vascular lesions requiring multidisciplinary care. Embolization is the primary treatment, with surgery considered for residual AVMs.

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Area of Science:

  • Interventional Radiology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Arteriovenous malformations (AVMs) are congenital, progressive vascular lesions characterized by abnormal shunting.
  • Complications include bleeding, skin ulceration, and cardiac failure, necessitating expert management.
  • Interventional radiologists are crucial for diagnosis and endovascular treatment planning.

Purpose of the Study:

  • To outline the diagnostic and therapeutic role of interventional radiology in managing AVMs.
  • To emphasize the importance of a multidisciplinary approach in AVM patient care.
  • To review current endovascular treatment strategies and emerging research.

Main Methods:

  • Clinical evaluation and Schobinger classification for diagnosis and intervention indication.
  • Doppler ultrasound, MR angiography, and CT angiography for imaging.
  • Digital subtraction angiography (DSA) for procedural guidance and lesion classification.

Main Results:

  • Embolization is the first-line treatment for symptomatic or progressive AVMs.
  • Various endovascular techniques and agents (ethanol, glue, Onyx, coils) are employed based on lesion anatomy.
  • Surgery may be necessary for residual AVMs post-embolization.

Conclusions:

  • Symptomatic or evolutive AVMs warrant treatment, with embolization as the primary modality.
  • Anatomical classification systems guide therapeutic approach selection.
  • While pharmacologic treatments are under investigation, current management relies on interventional and surgical techniques.