Hemodynamic changes of arteriovenous malformation and endovascular embolization

Objective: To analyze the hemodynamic changes caused by arteriovenous malformation (AVM) and AVM embolization through a meta-analysis of the existing literature. Method: Search for relevant studies on PubMed/Medline until November 7, 2023, and further screen the bibliographies of relevant studies to ensure comprehensive search. According to the PRISMA guidelines, manuscripts were selected to provide local hemodynamic information on AVM arterial feeders and drainage veins. Result: A total of 13 studies were included in the final analysis. The diameter of the supplying artery (y = 0.002x + 2.24, R² = 0.99) and flow velocity (y = 0.09x + 54.55, R² = 0.92) had a positive linear relationship with cerebral blood flow. The pressure difference through the small AVM nidus was higher than that in the large AVM, with values of (y = -12.23x + 101.39, R² = 0.96). There was a negative linear correlation between the sessions of AVM embolization and blood flow (1 session: y = -150.7x + 564.97, R² = 0.98 and 4 sessions: y = -118.81x + 750.07, R² = 0.99). There was a positive linear relationship between the increase in arterial pressure, peri-AVM parenchymal perfusion, and the percentage of occlusion in the medium-sized AVMs. However, this correlation was a nonlinear relationship between elevated arterial pressure, peri-AVM parenchymal perfusion, and the percentage of large AVM occlusion. Conclusion: The hemodynamic changes of AVM (in the feeding arteries, compartments of AVM, and draining veins) follow a linear relationship. The impact of embolization on hemodynamics in medium and small AVMs follows a linear relationship. The impact of embolization of large AVMs on hemodynamics follows a nonlinear relationship.