Endovascular treatment of cerebral arteriovenous malformations: Indications, techniques, outcome, and complications

Untreated cerebral AVMs carry a significant risk of long-term morbidity and mortality. Endovascular embolization has evolved into an important treatment option for most AVMs, whether it is used as an adjunct or as the primary therapy. Although sometimes a challenge to use, liquid cyanoacrylate derivatives have become the material of choice for most practitioners performing endovascular AVM embolization. In addition, advances in flow-guided microcatheter technology have enabled safer access to ever more hard-to-reach areas of the cerebral vasculature. In the current era, the treatment of cerebral AVMs seems to be best approached from a multidisciplinary standpoint at facilities where the major treatment modalities of microsurgery, stereotactic radiosurgery, and endovascular embolization are all available.