[Endovascular embolization in treatment of peripheral arteriovenous malformations (literature review)]

Arteriovenous malformations (AVMs) are the most aggressive type of vascular malformations. They are characterized by a progressive and relapsing course, as well as by a high number of clinically significant complications. Over the past two decades, endovascular treatment of AVMs has advanced rapidly, thanks to improvements in angiographic classification, treatment approaches, and embolization materials and tools. However, due to the rarity of the condition, large-scale studies reporting clinical outcomes of embolization for AVMs remain limited. Besides, the contemporary literature lacks uniformity in defining the outcomes that should be analyzed to evaluate treatment efficacy. For this reason, results from various clinical trials cannot be consolidated, complicating the development of evidence-based recommendations.

To analyze literature data and review recent studies describing treatment outcomes of peripheral AVMs.

This study analyzed over 170 full-text English- and Russian-language publications from the past 10 years, sourced from PubMed, Google Scholar (English-language databases), eLibrary and the Russian Science Citation Index (RSCI, Russian-language databases). The publications cover various aspects of the management, diagnosis, and treatment of patients with peripheral AVMs.

The currently available data on the definition, prevalence, and treatment of AVMs were systematized and presented herein. A structured table summarizing the findings of recent studies on endovascular treatment of peripheral AVMs is provided. This is followed by discussing the key trends and challenges in the research and management of this pathology.

Most of recent domestic and foreign publications on endovascular treatment of peripheral AVMs are case reports or case series. The high recurrence rates and need for multi-stage treatment underscore the importance of advancing embolization methods and technologies. International literature increasingly includes studies with larger patient cohorts, though most remain retrospective and single-center. Research focuses on outcomes of using various embolic agents and combining endovascular with surgical approaches. The universal use of transarterial, transvenous and percutaneous embolization methods or their combinations has proven its usefulness and effectiveness. Advanced surgical experience, technical tools and a wider range of embolic agents now allow previously impossible interventions to be performed, improving quality of life or achieving complete cure even in extensive, severe cases.