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Developmental venous anomaly with radiation-induced arteriovenous malformation
Wei Jiang1, Qiao Zuo1, Jianmin Liu2
1Neurovascular Center, the First Affiliated Hospital of Naval Medical University, Shanghai, 200433, China.
Summary
Developmental venous anomalies (DVAs) are congenital variations. Inappropriate radiosurgery disrupting DVA veins can lead to secondary arteriovenous malformations (AVMs), highlighting the importance of preserving venous integrity.
Area of Science:
- Neurology
- Vascular Surgery
- Radiosurgery
Background:
- Developmental venous anomaly (DVA) is a common congenital vascular malformation.
- The etiology of de novo arteriovenous malformation (AVM) formation within DVAs is poorly understood.
- Limited reports exist on DVAs associated with AVMs in the same territory.
Observation:
- A case study observed the effects of radiosurgery on DVA draining veins.
- Inappropriate radiosurgery led to disruption of DVA radicles.
- This disruption resulted in secondary de novo AVM and hemodynamic aneurysm formation.
Findings:
- Outflow disturbance from disrupted DVA collecting veins is a potential cause of de novo AVM formation.
- The study demonstrates a sequential process linking DVA treatment to AVM development.
- Preserving the integrity of DVA collecting veins is crucial during treatment.
Implications:
- This finding suggests a novel mechanism for secondary AVM formation.
- It underscores the critical need for careful consideration of venous drainage in DVA treatment strategies.
- Radiosurgery protocols for DVAs may require re-evaluation to prevent iatrogenic AVMs.
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