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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

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Published on: October 20, 2017

Peripheral arteriovenous malformations: Diagnosis and future prospects.

Julien Coulie¹, Miikka Vikkula², Laurence M Boon¹

¹Division of Plastic Surgery, Cliniques Universitaires Saint-Luc, University of Louvain, Brussels, Belgium; Center for Vascular Anomalies, Cliniques Universitaires Saint-Luc, University of Louvain, VASCERN VASCA European Reference Centre, Brussels, Belgium; Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium.

Presse Medicale (Paris, France : 1983)

|June 11, 2025

Summary

Peripheral arteriovenous malformations (AVMs) are rare vascular anomalies often linked to the RAS/RAF/MEK/ERK pathway. Current treatments face challenges with recurrence, necessitating improved, individualized therapies.

Keywords:

Arteriovenous malformation High-flow vascular malformation Vascular anomaly

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Area of Science:

Vascular Biology and Medicine
Medical Genetics
Interventional Radiology

Background:

Peripheral arteriovenous malformations (AVMs) are rare, high-flow vascular anomalies.
They arise from errors in vasculogenesis/angiogenesis, often involving the RAS/RAF/MEK/ERK pathway.
AVMs present progressively, causing pain, bleeding, and potentially high-output cardiac failure.

Purpose of the Study:

To review diagnostic and therapeutic challenges of peripheral AVMs.
To highlight current management strategies and their limitations.
To discuss emerging therapies and future research directions for improved patient outcomes.

Main Methods:

Review of advanced imaging modalities (Doppler ultrasonography, MRI, angiography) for diagnosis.
Analysis of current treatment strategies including embolization, surgery, and endovascular therapies.
Evaluation of emerging antiangiogenic therapies (thalidomide, MEK inhibitors) and molecular genetics insights.

Main Results:

Accurate diagnosis requires advanced imaging for lesion extent and flow dynamics.
Incomplete treatment leads to high recurrence rates, underscoring the need for complete nidus removal.
Emerging therapies show promise in reducing recurrence and improving outcomes.

Conclusions:

Standardized treatment protocols integrating clinical, anatomical, and genetic data are needed.
Syndromic AVMs require broader considerations; molecular genetics offers targeted therapy potential.
Multidisciplinary approaches and refined combination therapies are crucial for individualized patient care.