Embolization and radiosurgery for arteriovenous malformations

Andres R Plasencia, Alejandro Santillan, Andres R Plasencia, Alejandro Santillan

Abstract

The treatment of arteriovenous malformations (AVMs) requires a multidisciplinary management including microsurgery, endovascular embolization, and stereotactic radiosurgery (SRS). This article reviews the recent advancements in the multimodality treatment of patients with AVMs using endovascular neurosurgery and SRS. We describe the natural history of AVMs and the role of endovascular and radiosurgical treatment as well as their interplay in the management of these complex vascular lesions. Also, we present some representative cases treated at our institution.

Keywords: Arteriovenous malformation; embolization; stereotactic radiosurgery.

Figures

Figure 1
Figure 1
Curative embolization of a Spetzler-Martin grade II arteriovenous malformation (AVM) in an 18-year-old male. (a) Preembolization digital subtraction angiogram (DSA) showing a left premotor AVM. (b) An oblique DSA view shows an associated intranidal aneurysm suspicious to be the source of bleeding. (c) Superselective microcatheterization of the main AVM feeder right before embolization with n-butyl cyanoacrilate. (d) Follow-up DSA 42 months later. The AVM is cured without any clinical sequelae
Figure 2
Figure 2
Preradiosurgical embolization of an intranidal aneurysm. (a) Computed tomography scan showing a basal ganglia hematoma. (b) Digital subtraction angiogram (DSA) of the right internal carotid artery (ICA) showing an intranidal aneurysm, identified as the bleeding source. (c) A lateral lenticulostriate artery was catheterized to embolize the aneurysm with n-butyl cyanoacrilate. (d) DSA after embolization shows disappearance of aneurysm. The residual arteriovenous malformation (AVM) was then treated with stereotactic radiosurgery (SRS). (e) A DSA of the right ICA performed 28 months after SRS shows complete cure of the AVM
Figure 3
Figure 3
Rolandic arteriovenous malformation (AVM) with proximal flor-related wide neck posterior communicating aneurysm before nidus embolization. (a) Digital subtraction angiogram of the right internal carotid artery showing both lesions. (b) The aneurysm was totally occluded with stent-assisted coil embolization as seen in (c). The AVM nidus is scheduled to be embolized and then treated definitely with SRS
Figure 4
Figure 4
Embolization of an arteriovenous fistula before stereotactic radiosurgery (SRS). This high-flow AV fistula was associated with a left temporal arteriovenous malformation (AVM). The huge varix resulted from venous hypertension obscured the true AVM size. (a) Pre-embolization MRI. (b) Pre-embolization digital subtraction angiogram. (c) Post-embolization MRI (d) Post-embolization DSA showing a very small residual AVM. The patient was subsequently treated with SRS
Figure 5
Figure 5
Combined embolization and stereotactic radiosurgery (SRS) for a large arteriovenous malformation Spetzler–Martin grade IV of the left temporal lobe. (a) Digital subtraction angiogram of the left internal carotid artery showing a lesion that occupies most of the temporal lobe on the dominant hemisphere causing significant “vascular steal phenomenon.” (b) Seven years after 4 embolizations and 2 SRS, only a small dural remnant is seen. The patient continues asymptomatic
Figure 6
Figure 6
Stereotactic radiosurgery for multiple arteriovenous malformations (AVMs) associated with hereditary hemorrhagic telangiectasia. A 25-year-old female with two AVMs located in the right frontoorbital and left prefrontal lobes. (a) Digital subtraction angiogram of the right internal carotid artery before stereotactic radiosurgery and (b) 3 years later. Both AVMs were cured without any clinical sequelae
Figure 7
Figure 7
Staged-volume stereotactic radiosurgery (SRS). A 21-year-old man presented with intraventricular hemorrhage caused by a large corpus callosum arteriovenous malformation (AVM). The patient had an uneventful recovery. (a) Digital subtraction angiogram before SRS. (b) Two years later, after the first SRS the rostral part of the AVM disappeared. (c) Two years following the second SRS, the AVM was completely cured
Figure 8
Figure 8
Large arteriovenous malformation (AVM) treated with two sessions of staged stereotactic radiosurgery (SRS) with transient complication in a 37-year-old male presenting with headache. (a) Digital subtraction angiogram (DSA) showing a large right frontal AVM. (b) Axial T2W MRI before SRS. Six months after the second SRS, the patient presented with several episodes of subintrant generalized seizures and post-ictal left hemiparesis managed with corticosteroids and antiepileptics, that (c) correspond to a T2W hyperintense signal. (d) DSA performed 26 months after the second SRS shows cure of the AVM. The patient is seizure-free and without any neurological sequelae
Figure 9
Figure 9
Salvage embolization after stereotactic radiosurgery (SRS) in a 42-year-old male presenting with seizures. (a) A high-flow arteriovenous malformation (AVM), presumably associated with an intranidal AVF was treated with SRS. (b) Eighteen months after SRS, the AVM bled. The patient had sequelae of a left upper limb paresis. (c) A follow-up digital subtraction angiogram showed a small residual nidus in advanced obliteration status. (d) Superselective microcatheterization of the dominant feeder was followed by n-butyl cyanoacrilate embolization. (e) Marked flow stagnation after embolization. (f) Two years after SRS and 6 months after rescue embolization, the AVM is cured

References

    1. Arteriovenous malformations of the brain in adults. N Engl J Med. 1999;340:1812–8.
    1. Al-Shahi R, Fang JS, Lewis SC, Warlow CP. Prevalence of adults with brain arteriovenous malformations: A community based study in Scotland using capture-recapture analysis. J Neurol Neurosurg Psychiatry. 2002;73:547–51.
    1. Alexander E, Loeffler JS, Lunsford LD. Stereotactic Radiosurgery. New York: McGraw-Hill; 1993.
    1. Andrade-Souza YM, Ramani M, Scora D, Tsao MN, terBrugge K, Schwartz ML. Embolization before radiosurgery reduces the obliteration rate of arteriovenous malformations. Neurosurgery. 2007;60:443–51. discussion 451-2.
    1. Andrade-Souza YM, Ramani M, Scora D, Tsao MN, TerBrugge K, Schwartz ML. Radiosurgical treatment for rolandic arteriovenous malformations. J Neurosurg. 2006;105:689–97.
    1. Andrade-Souza YM, Zadeh G, Scora D, Tsao MN, Schwartz ML. Radiosurgery for basal ganglia, internal capsule, and thalamus arteriovenous malformation: Clinical outcome. Neurosurgery. 2005;56:56–63. discussion 63-4.
    1. Andreou A, Ioannidis I, Lalloo S, Nickolaos N, Byrne JV. Endovascular treatment of intracranial microarteriovenous malformations. J Neurosurg. 2008;109:1091–7.
    1. ApSimon HT, Reef H, Phadke RV, Popovic EA. A population-based study of brain arteriovenous malformation: Long-term treatment outcomes. Stroke. 2002;33:2794–800.
    1. Attia M, Menhel J, Alezra D, Pffefer R, Spiegelmann R. Radiosurgery--LINAC or gamma knife: 20 years of controversy revisited. Isr Med Assoc J. 2005;7:583–8.
    1. Ayad M, Eskioglu E, Mericle RA. Onyx: A unique neuroembolic agent. Expert Rev Med Devices. 2006;3:705–15.
    1. Back AG, Zeck O, Shkedy C, Shedden PM. Staged embolization with staged gamma knife radiosurgery to treat a large AVM. Can J Neurol Sci. 2009;36:500–3.
    1. Batjer H, Suss RA, Samson D. Intracranial arteriovenous malformations associated with aneurysms. Neurosurgery. 1986;18:29–35.
    1. Betti O, Derechinsky V. [Multiple-beam stereotaxic irradiation] Neurochirurgie. 1983;29:295–8.
    1. Betti OO, Munari C, Rosler R. Stereotactic radiosurgery with the linear accelerator: Treatment of arteriovenous malformations. Neurosurgery. 1989;24:311–21.
    1. Bing F, Doucet R, Lacroix F, Bahary JP, Darsaut T, Roy D, et al. Liquid embolization material reduces the delivered radiation dose: Clinical myth or reality? AJNR Am J Neuroradiol. 2012;33:320–2.
    1. Bollet MA, Anxionnat R, Buchheit I, Bey P, Cordebar A, Jay N, et al. Efficacy and morbidity of arc-therapy radiosurgery for cerebral arteriovenous malformations: A comparison with the natural history. Int J Radiat Oncol Biol Phys. 2004;58:1353–63.
    1. Brothers MF, Kaufmann JC, Fox AJ, Deveikis JP. n-Butyl 2-cyanoacrylate-substitute for IBCA in interventional neuroradiology: histopathologic and polymerization time studies. AJNR Am J Neuroradiol. 1989;10:777–86.
    1. Brown RD, Jr, Wiebers DO, Forbes GS. Unruptured intracranial aneurysms and arteriovenous malformations: Frequency of intracranial hemorrhage and relationship of lesions. J Neurosurg. 1990;73:859–63.
    1. Brown RD, Jr, Wiebers DO, Torner JC, O’Fallon WM. Frequency of intracranial hemorrhage as a presenting symptom and subtype analysis: A population-based study of intracranial vascular malformations in Olmsted Country, Minnesota. J Neurosurg. 1996;85:29–32.
    1. Buis DR, Lagerwaard FJ, Barkhof F, Dirven CM, Lycklama GJ, Meijer OW, et al. Stereotactic radiosurgery for brain AVMs: Role of interobserver variation in target definition on digital subtraction angiography. Int J Radiat Oncol Biol Phys. 2005;62:246–52.
    1. Chang JH, Chang JW, Park YG, Chung SS. Factors related to complete occlusion of arteriovenous malformations after gamma knife radiosurgery. J Neurosurg. 2000;93(Suppl 3):96–101.
    1. Choi JH, Mohr JP. Brain arteriovenous malformations in adults. Lancet Neurol. 2005;4:299–308.
    1. Chung WY, Shiau CY, Wu HM, Liu KD, Guo WY, Wang LW, et al. Staged radiosurgery for extra-large cerebral arteriovenous malformations: Method, implementation, and results. J Neurosurg. 2008;109(Suppl):S65–72.
    1. Cockroft KM, Thompson RC, Steinberg GK. Aneurysms and arteriovenous malformations. Neurosurg Clin N Am. 1998;9:565–76.
    1. Colombo F, Pozza F, Chierego G, Casentini L, De Luca G, Francescon P. Linear accelerator radiosurgery of cerebral arteriovenous malformations: An update. Neurosurgery. 1994;34:14–20. discussion 20-1.
    1. Crawford PM, West CR, Chadwick DW, Shaw MD. Arteriovenous malformations of the brain: Natural history in unoperated patients. J Neurol Neurosurg Psychiatry. 1986;49:1–10.
    1. Crocco A. Arteriovenous malformations in the basal ganglia region: Gamma Knife radiosurgery as first choice treatment in selected cases. J Neurosurg Sci. 2002;46:43–54.
    1. Cunha e Sa MJ, Stein BM, Solomon RA, McCormick PC. The treatment of associated intracranial aneurysms and arteriovenous malformations. J Neurosurg. 1992;77:853–9.
    1. da Costa L, Wallace MC, Ter Brugge KG, O’Kelly C, Willinsky RA, Tymianski M. The natural history and predictive features of hemorrhage from brain arteriovenous malformations. Stroke. 2009;40:100–5.
    1. Dawson RC, 3rd, Tarr RW, Hecht ST, Jungreis CA, Lunsford LD, Coffey R, et al. Treatment of arteriovenous malformations of the brain with combined embolization and stereotactic radiosurgery: Results after 1 and 2 years. AJNR Am J Neuroradiol. 1990;11:857–64.
    1. De Salles AF, Goetsch SJ. Stereotactic Surgery and Radiosurgery. Madison, WI: Medical Physics Publishing; 1993.
    1. DeMeritt JS, Pile-Spellman J, Mast H, Moohan N, Lu DC, Young WL, et al. Outcome analysis of preoperative embolization with N-butyl cyanoacrylate in cerebral arteriovenous malformations. AJNR Am J Neuroradiol. 1995;16:1801–7.
    1. Deruty R, Pelissou-Guyotat I, Amat D, Mottolese C, Bascoulergue Y, Turjman F, et al. Complications after multidisciplinary treatment of cerebral arteriovenous malformations. Acta Neurochir (Wien) 1996;138:119–31.
    1. Douglas JG, Goodkin R. Treatment of arteriovenous malformations using Gamma Knife surgery: The experience at the University of Washington from 2000 to 2005. J Neurosurg. 2008;109(Suppl):S51–6.
    1. Duong DH, Young WL, Vang MC, Sciacca RR, Mast H, Koennecke HC, et al. Feeding artery pressure and venous drainage pattern are primary determinants of hemorrhage from cerebral arteriovenous malformations. Stroke. 1998;29:1167–76.
    1. Ellis TL, Friedman WA, Bova FJ, Kubilis PS, Buatti JM. Analysis of treatment failure after radiosurgery for arteriovenous malformations. J Neurosurg. 1998;89:104–10.
    1. Engenhart R, Wowra B, Debus J, Kimmig BN, Hover KH, Lorenz W, et al. The role of high-dose, single-fraction irradiation in small and large intracranial arteriovenous malformations. Int J Radiat Oncol Biol Phys. 1994;30:521–9.
    1. Ezura M, Takahashi A, Jokura H, Shirane R, Yoshimoto T. Endovascular treatment of aneurysms associated with cerebral arteriovenous malformations: Experiences after the introduction of Guglielmi detachable coils. J Clin Neurosci. 2000;7(Suppl 1):S14–8.
    1. Fleetwood IG, Marcellus ML, Levy RP, Marks MP, Steinberg GK. Deep arteriovenous malformations of the basal ganglia and thalamus: Natural history. J Neurosurg. 2003;98:747–50.
    1. Fleetwood IG, Steinberg GK. Arteriovenous malformations. Lancet. 2002;359:863–73.
    1. Flickinger JC. An integrated logistic formula for prediction of complications from radiosurgery. Int J Radiat Oncol Biol Phys. 1989;17:879–85.
    1. Flickinger JC, Kondziolka D, Maitz AH, Lunsford LD. An analysis of the dose-response for arteriovenous malformation radiosurgery and other factors affecting obliteration. Radiother Oncol. 2002;63:347–54.
    1. Foote KD, Friedman WA, Ellis TL, Bova FJ, Buatti JM, Meeks SL. Salvage retreatment after failure of radiosurgery in patients with arteriovenous malformations. J Neurosurg. 2003;98:337–41.
    1. Fournier D, Terbrugge K, Rodesch G, Lasjaunias P. Revascularization of brain arteriovenous malformations after embolization with bucrylate. Neuroradiology. 1990;32:497–501.
    1. Fournier D, TerBrugge KG, Willinsky R, Lasjaunias P, Montanera W. Endovascular treatment of intracerebral arteriovenous malformations: Experience in 49 cases. J Neurosurg. 1991;75:228–33.
    1. Fox AJ, Girvin JP, Vinuela F, Drake CG. Rolandic arteriovenous malformations: Improvement in limb function by IBC embolization. AJNR Am J Neuroradiol. 1985;6:575–82.
    1. Friedman WA, Bova FJ. Radiosurgery for arteriovenous malformations. Neurol Res. 2011;33:803–19.
    1. Friedman WA, Buatti JM, Bova FJ, Mendenhall WM. A practical guide. New York: Springer-Verlag; 1997. Linac Radiosurgery.
    1. Frizzel RT, Fisher WS., 3rd Cure, morbidity, and mortality associated with embolization of brain arteriovenous malformations: A review of 1246 patients in 32 series over a 35-year period. Neurosurgery. 1995;37:1031–9. discussion 1039-40.
    1. Ganz JC. Gamma Knife Surgery. 2nd ed. New York: Springer-Verlag; 1997.
    1. Gobin YP, Laurent A, Merienne L, Schlienger M, Aymard A, Houdart E, et al. Treatment of brain arteriovenous malformations by embolization and radiosurgery. J Neurosurg. 1996;85:19–28.
    1. Graf CJ, Perret GE, Torner JC. Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg. 1983;58:331–7.
    1. Guo WY, Wikholm G, Karlsson B, Lindquist C, Svendsen P, Ericson K. Combined embolization and gamma knife radiosurgery for cerebral arteriovenous malformations. Acta Radiol. 1993;34:600–6.
    1. Ha JK, Choi SK, Kim TS, Rhee BA, Lim YJ. Multi-modality treatment for intracranial arteriovenous malformation associated with arterial aneurysm. J Korean Neurosurg Soc. 2009;46:116–22.
    1. Hadjipanayis CG, Levy EI, Niranjan A, Firlik AD, Kondziolka D, Flickinger JC, et al. Stereotactic radiosurgery for motor cortex region arteriovenous malformations. Neurosurgery. 2001;48:70–6. discussion 76-7.
    1. Hamada J, Kai Y, Morioka M, Kazekawa K, Ishimaru Y, Iwata H, et al. A mixture of ethylene vinyl alcohol copolymer and ethanol yielding a nonadhesive liquid embolic agent to treat cerebral arteriovenous malformations: Initial clinical experience. J Neurosurg. 2002;97:881–8.
    1. Hartmann A, Mast H, Mohr JP, Koennecke HC, Osipov A, Pile-Spellman J, et al. Morbidity of intracranial hemorrhage in patients with cerebral arteriovenous malformation. Stroke. 1998;29:931–4.
    1. Hartmann A, Pile-Spellman J, Stapf C, Sciacca RR, Faulstich A, Mohr JP, et al. Risk of endovascular treatment of brain arteriovenous malformations. Stroke. 2002;33:1816–20.
    1. Hauck EF, Welch BG, White JA, Purdy PD, Pride LG, Samson D. Preoperative embolization of cerebral arteriovenous malformations with onyx. AJNR Am J Neuroradiol. 2009;30:492–5.
    1. Hauswald H, Milker-Zabel S, Sterzing F, Schlegel W, Debus J, Zabel-du Bois A. Repeated linac-based radiosurgery in high-grade cerebral arteriovenous-malformations (AVM) Spetzler-Martin grade III to IV previously treated with radiosurgery. Radiother Oncol. 2011;98:217–22.
    1. Haw CS, terBrugge K, Willinsky R, Tomlinson G. Complications of embolization of arteriovenous malformations of the brain. J Neurosurg. 2006;104:226–32.
    1. Henkes H, Nahser HC, Berg-Dammer E, Weber W, Lange S, Kuhne D. Endovascular therapy of brain AVMs prior to radiosurgery. Neurol Res. 1998;20:479–92.
    1. Hodgson TJ, Kemeny AA, Gholkar A, Deasy N. Embolization of residual fistula following stereotactic radiosurgery in cerebral arteriovenous malformations. AJNR Am J Neuroradiol. 2009;30:109–10.
    1. Hofmeister C, Stapf C, Hartmann A, Sciacca RR, Mansmann U, terBrugge K, et al. Demographic, morphological, and clinical characteristics of 1289 patients with brain arteriovenous malformation. Stroke. 2000;31:1307–10.
    1. Jafar JJ, Davis AJ, Berenstein A, Choi IS, Kupersmith MJ. The effect of embolization with N-butyl cyanoacrylate prior to surgical resection of cerebral arteriovenous malformations. J Neurosurg. 1993;78:60–9.
    1. Jahan R, Murayama Y, Gobin YP, Duckwiler GR, Vinters HV, Vinuela F. Embolization of arteriovenous malformations with Onyx: Clinicopathological experience in 23 patients. Neurosurgery. 2001;48:984–95. discussion 995-7.
    1. Jayaraman MV, Marcellus ML, Hamilton S, Do HM, Campbell D, Chang SD, et al. Neurologic complications of arteriovenous malformation embolization using liquid embolic agents. AJNR American J Neuroradiol. 2008;29:242–6.
    1. Kader A, Young WL, Pile-Spellman J, Mast H, Sciacca RR, Mohr JP, et al. The influence of hemodynamic and anatomic factors on hemorrhage from cerebral arteriovenous malformations. Neurosurgery. 1994;34:801–7. discussion 807-8.
    1. Kano H, Kondziolka D, Flickinger JC, Park KJ, Parry PV, Yang HC, et al. Stereotactic radiosurgery for arteriovenous malformations, Part 6: Multistaged volumetric management of large arteriovenous malformations. J Neurosurg. 2012;116:54–65.
    1. Kano H, Kondziolka D, Flickinger JC, Yang HC, Flannery TJ, Niranjan A, et al. Stereotactic radiosurgery for arteriovenous malformations, Part 5: Management of brainstem arteriovenous malformations. J Neurosurg. 2012;116:44–53.
    1. Karlsson B, Jokura H, Yamamoto M, Soderman M, Lax I. Is repeated radiosurgery an alternative to staged radiosurgery for very large brain arteriovenous malformations? J Neurosurg. 2007;107:740–4.
    1. Karlsson B, Kihlstrom L, Lindquist C, Steiner L. Gamma knife surgery for previously irradiated arteriovenous malformations. Neurosurgery. 1998;42:1–5. discussion 5-6.
    1. Karlsson B, Lindquist C, Steiner L. Prediction of obliteration after gamma knife surgery for cerebral arteriovenous malformations. Neurosurgery. 1997;40:425–30. discussion 430-1.
    1. Kemeny AA, Dias PS, Forster DM. Results of stereotactic radiosurgery of arteriovenous malformations: An analysis of 52 cases. J Neurol Neurosurg Psychiatry. 1989;52:554–8.
    1. Khaw AV, Mohr JP, Sciacca RR, Schumacher HC, Hartmann A, Pile-Spellman J, et al. Association of infratentorial brain arteriovenous malformations with hemorrhage at initial presentation. Stroke. 2004;35:660–3.
    1. Kikuchi K, Kowada M, Sasajima H. Vascular malformations of the brain in hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber disease) Surg Neurol. 1994;41:374–80.
    1. Kim EJ, Halim AX, Dowd CF, Lawton MT, Singh V, Bennett J, et al. The relationship of coexisting extranidal aneurysms to intracranial hemorrhage in patients harboring brain arteriovenous malformations. Neurosurgery. 2004;54:1349–57. discussion 1357-8.
    1. Kiran NA, Kale SS, Kasliwal MK, Vaishya S, Gupta A, Sharma M Singh, et al. Gamma knife radiosurgery for arteriovenous malformations of basal ganglia, thalamus and brainstem--A retrospective study comparing the results with that for AVMs at other intracranial locations. Acta Neurochir (Wien) 2009;151:1575–82.
    1. Kjellberg RN, Hanamura T, Davis KR, Lyons SL, Adams RD. Bragg-peak proton-beam therapy for arteriovenous malformations of the brain. N Engl J Med. 1983;309:269–74.
    1. Kondziolka D, Nixon BJ, Lasjaunias P, Tucker WS, TerBrugge K, Spiegel SM. Cerebral arteriovenous malformations with associated arterial aneurysms: Hemodynamic and therapeutic considerations. Can J Neurol Sci. 1988;15:130–4.
    1. Krings T, Hans FJ, Geibprasert S, Terbrugge K. Partial “targeted” embolisation of brain arteriovenous malformations. Eur Radiol. 2010;20:2723–31.
    1. Kusske JA, Kelly WA. Embolization and reduction of the “steal” syndrome in cerebral arteriovenous malformations. J Neurosurg. 1974;40:313–21.
    1. Kwon Y, Jeon SR, Kim JH, Lee JK, Ra DS, Lee DJ, et al. Analysis of the causes of treatment failure in gamma knife radiosurgery for intracranial arteriovenous malformations. J Neurosurg. 2000;93(Suppl 3):S104–6.
    1. Ledezma CJ, Hoh BL, Carter BS, Pryor JC, Putman CM, Ogilvy CS. Complications of cerebral arteriovenous malformation embolization: Multivariate analysis of predictive factors. Neurosurgery. 2006;58:602–11. discussion 602-11.
    1. Leksell L. The stereotaxic method and radiosurgery of the brain. Acta Chir Scand. 1951;102:316–9.
    1. Lemme-Plaghos L, Schonholz C, Willis R. Combination of embolization and radiosurgery in the treatment of arteriovenous malformations. In: Steiner L, editor. Radiosurgery: Baseline ad trends. New York: Raven Press; 1992. p. 195.
    1. Lindqvist M, Karlsson B, Guo WY, Kihlstrom L, Lippitz B, Yamamoto M. Angiographic long-term follow-up data for arteriovenous malformations previously proven to be obliterated after gamma knife radiosurgery. Neurosurgery. 2000;46:803–8. discussion 809-10.
    1. Lindqvist M, Steiner L, Blomgren H, Arndt J, Berggren BM. Stereotactic radiation therapy of intracranial arteriovenous malformations. Acta Radiol. 1986;369:610–3.
    1. Liscak R, Vladyka V, Simonova G, Urgosik D, Novotny J, Jr, Janouskova L, et al. Arteriovenous malformations after Leksell gamma knife radiosurgery: Rate of obliteration and complications. Neurosurgery. 2007;60:1005–14. discussion 1015-6.
    1. Locksley HB. Natural history of subarachnoid hemorrhage, intracranial aneurysms and arteriovenous malformations. Based on 6368 cases in the cooperative study. J Neurosurg. 1966;25:219–39.
    1. Luessenhop AJ, Mujica PH. Embolization of segments of the circle of Willis and adjacent branches for management of certain inoperable cerebral arteriovenous malformations. J Neurosurg. 1981;54:573–82.
    1. Luessenhop AJ, Spence WT. Artificial embolization of cerebral arteries. Report of use in a case of arteriovenous malformation. J Am Med Assoc. 1960;172:1153–5.
    1. Lundqvist C, Wikholm G, Svendsen P. Embolization of cerebral arteriovenous malformations: Part II--Aspects of complications and late outcome. Neurosurgery. 1996;39:460–7. discussion 467-9.
    1. Lunsford LD, Kondziolka D, Flickinger JC, Bissonette DJ, Jungreis CA, Maitz AH, et al. Stereotactic radiosurgery for arteriovenous malformations of the brain. J Neurosurg. 1991;75:512–24.
    1. Lv X, Wu Z, Jiang C, Li Y, Yang X, Zhang Y, et al. Complication risk of endovascular embolization for cerebral arteriovenous malformation. Eur J Radiol. 2011;80:776–9.
    1. Maesawa S, Flickinger JC, Kondziolka D, Lunsford LD. Repeated radiosurgery for incompletely obliterated arteriovenous malformations. J Neurosurg. 2000;92:961–70.
    1. Mansmann U, Meisel J, Brock M, Rodesch G, Alvarez H, Lasjaunias P. Factors associated with intracranial hemorrhage in cases of cerebral arteriovenous malformation. Neurosurgery. 2000;46:272–9. discussion 279-81.
    1. Marks MP, Lane B, Steinberg GK, Chang PJ. Hemorrhage in intracerebral arteriovenous malformations: Angiographic determinants. Radiology. 1990;176:807–13.
    1. Martin NA, Khanna R, Doberstein C, Bentson J. Therapeutic embolization of arteriovenous malformations: The case for and against. Clin Neurosurg. 2000;46:295–318.
    1. Maruyama K, Shin M, Tago M, Kurita H, Kawamoto S, Morita A, et al. Gamma knife surgery for arteriovenous malformations involving the corpus callosum. J Neurosurg. 2005;102(Suppl):S49–52.
    1. Massager N, Regis J, Kondziolka D, Njee T, Levivier M. Gamma knife radiosurgery for brainstem arteriovenous malformations: Preliminary results. J Neurosurg. 2000;93(Suppl 3):S102–3.
    1. Massoud TF, Ji C, Guglielmi G, Vinuela F. Endovascular treatment of arteriovenous malformations with selective intranidal occlusion by detachable platinum electrodes: Technical feasibility in a swine model. AJNR Am J Neuroradiol. 1996;17:1459–66.
    1. Mathis JA, Barr JD, Horton JA, Jungreis CA, Lunsford LD, Kondziolka DS, et al. The efficacy of particulate embolization combined with stereotactic radiosurgery for treatment of large arteriovenous malformations of the brain. AJNR Am J Neuroradiol. 1995;16:299–306.
    1. Meisel HJ, Mansmann U, Alvarez H, Rodesch G, Brock M, Lasjaunias P. Cerebral arteriovenous malformations and associated aneurysms: Analysis of 305 cases from a series of 662 patients. Neurosurgery. 2000;46:793–800. discussion 800-2.
    1. Meisel HJ, Mansmann U, Alvarez H, Rodesch G, Brock M, Lasjaunias P. Effect of partial targeted N-butyl-cyano-acrylate embolization in brain AVM. Acta Neurochir (Wien) 2002;144:879–87. discussion 888.
    1. Miyachi S, Negoro M, Okamoto T, Kobayashi T, Kida Y, Tanaka T, et al. Embolisation of cerebral arteriovenous malformations to assure successful subsequent radiosurgery. J Clin Neurosci. 2000;7(Suppl 1):S82–5.
    1. Miyasaka Y, Yada K, Ohwada T, Kitahara T, Kurata A, Irikura K. An analysis of the venous drainage system as a factor in hemorrhage from arteriovenous malformations. J Neurosurg. 1992;76:239–43.
    1. Mohr JP, Moskowitz AJ, Stapf C, Hartmann A, Lord K, Marshall SM, et al. The ARUBA trial: Current status, future hopes. Stroke. 2010;41:e537–40.
    1. Natarajan SK, Born D, Ghodke B, Britz GW, Sekhar LN. Histopathological changes in brain arteriovenous malformations after embolization using Onyx or N-butyl cyanoacrylate. Laboratory investigation. J Neurosurg. 2009;111:105–13.
    1. Ogilvy CS, Stieg PE, Awad I, Brown RD, Jr, Kondziolka D, Rosenwasser R, et al. AHA Scientific Statement: Recommendations for the management of intracranial arteriovenous malformations: A statement for healthcare professionals from a special writing group of the Stroke Council, American Stroke Association. Stroke. 2001;32:1458–71.
    1. Ondra SL, Troupp H, George ED, Schwab K. The natural history of symptomatic arteriovenous malformations of the brain: A 24-year follow-up assessment. J Neurosurg. 1990;73:387–91.
    1. Orio P, Stelzer KJ, Goodkin R, Douglas JG. Treatment of arteriovenous malformations with linear accelerator-based radiosurgery compared with Gamma Knife surgery. J Neurosurg. 2006;105(Suppl):S58–63.
    1. Perret G, Nishioka H. Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section VI. Arteriovenous malformations. An analysis of 545 cases of cranio-cerebral arteriovenous malformations and fistulae reported to the cooperative study. J Neurosurg. 1966;25:467–90.
    1. Piotin M, Ross IB, Weill A, Kothimbakam R, Moret J. Intracranial arterial aneurysms associated with arteriovenous malformations: Endovascular treatment. Radiology. 2001;220:506–13.
    1. Pollock BE, Flickinger JC, Lunsford LD, Bissonette DJ, Kondziolka D. Hemorrhage risk after stereotactic radiosurgery of cerebral arteriovenous malformations. Neurosurgery. 1996;38:652–9. discussion 659-61.
    1. Pollock BE, Flickinger JC, Lunsford LD, Maitz A, Kondziolka D. Factors associated with successful arteriovenous malformation radiosurgery. Neurosurgery. 1998;42:1239–44. discussion 1244-7.
    1. Pollock BE, Gorman DA, Brown PD. Radiosurgery for arteriovenous malformations of the basal ganglia, thalamus, and brainstem. J Neurosurg. 2004;100:210–4.
    1. Pollock BE, Kline RW, Stafford SL, Foote RL, Schomberg PJ. The rationale and technique of staged-volume arteriovenous malformation radiosurgery. Int J Radiat Oncol Biol Phys. 2000;48:817–24.
    1. Pollock BE, Kondziolka D, Lunsford LD, Bissonette D, Flickinger JC. Repeat stereotactic radiosurgery of arteriovenous malformations: Factors associated with incomplete obliteration. Neurosurgery. 1996;38:318–24.
    1. Pollock BE, Lunsford LD, Kondziolka D, Bissonette DJ, Flickinger JC. Stereotactic radiosurgery for postgeniculate visual pathway arteriovenous malformations. J Neurosurg. 1996;84:437–41.
    1. Rao VR, Mandalam KR, Gupta AK, Kumar S, Joseph S. Dissolution of isobutyl 2-cyanoacrylate on long-term follow-up. AJNR Am J Neuroradiol. 1989;10:135–41.
    1. Redekop G, TerBrugge K, Montanera W, Willinsky R. Arterial aneurysms associated with cerebral arteriovenous malformations: Classification, incidence, and risk of hemorrhage. J Neurosurg. 1998;89:539–46.
    1. Riina HA, Gobin YP. Grading and surgical planning for intracranial arteriovenous malformations. Neurosurg Focus. 2001;11:e3.
    1. Sasaki T, Kurita H, Saito I, Kawamoto S, Nemoto S, Terahara A, et al. Arteriovenous malformations in the basal ganglia and thalamus: management and results in 101 cases. J Neurosurg. 1998;88:285–92.
    1. Schlienger M, Atlan D, Lefkopoulos D, Merienne L, Touboul E, Missir O, et al. Linac radiosurgery for cerebral arteriovenous malformations: results in 169 patients. Int J Radiat Oncol Biol Phys. 2000;46:1135–42.
    1. Schlienger M, Nataf F, Lefkopoulos D, Mammar H, Missir O, Meder JF, et al. Repeat linear accelerator radiosurgery for cerebral arteriovenous malformations. Int J Radiat Oncol Biol Phys. 2003;56:529–36.
    1. Schmutz F, McAuliffe W, Anderson DM, Elliott JP, Eskridge JM, Winn HR. Embolization of cerebral arteriovenous malformations with silk: Histopathologic changes and hemorrhagic complications. AJNR Am J Neuroradiol. 1997;18:1233–7.
    1. Schwartz M. Stereotactic radiosurgery: Comparing different technologies. CMAJ. 1998;158:625–8.
    1. Shin M, Kawamoto S, Kurita H, Tago M, Sasaki T, Morita A, et al. Retrospective analysis of a 10-year experience of stereotactic radio surgery for arteriovenous malformations in children and adolescents. J Neurosurg. 2002;97:779–84.
    1. Shin M, Maruyama K, Kurita H, Kawamoto S, Tago M, Terahara A, et al. Analysis of nidus obliteration rates after gamma knife surgery for arteriovenous malformations based on long-term follow-up data: The University of Tokyo experience. J Neurosurg. 2004;101:18–24.
    1. Shtraus N, Schifter D, Corn BW, Maimon S, Alani S, Frolov V, et al. Radiosurgical treatment planning of AVM following embolization with Onyx: Possible dosage error in treatment planning can be averted. J Neurooncol. 2010;98:271–6.
    1. Sirin S, Kondziolka D, Niranjan A, Flickinger JC, Maitz AH, Lunsford LD. Prospective staged volume radiosurgery for large arteriovenous malformations: Indications and outcomes in otherwise untreatable patients. Neurosurgery. 2006;58:17–27. discussion 17-27.
    1. Sirin S, Kondziolka D, Niranjan A, Flickinger JC, Maitz AH, Lunsford LD. Prospective staged volume radiosurgery for large arteriovenous malformations: Indications and outcomes in otherwise untreatable patients. Neurosurgery. 2008;62(Suppl 2):S744–54.
    1. Soderman M, Andersson T, Karlsson B, Wallace MC, Edner G. Management of patients with brain arteriovenous malformations. Eur J Radiol. 2003;46:195–205.
    1. Souhami L, Olivier A, Podgorsak EB, Pla M, Pike GB. Radiosurgery of cerebral arteriovenous malformations with the dynamic stereotactic irradiation. Int J Radiat Oncol Biol Phys. 1990;19:775–82.
    1. Spetzler RF, Martin NA, Carter LP, Flom RA, Raudzens PA, Wilkinson E. Surgical management of large AVM's by staged embolization and operative excision. J Neurosurg. 1987;67:17–28.
    1. Spetzler RF, Wilson CB, Weinstein P, Mehdorn M, Townsend J, Telles D. Normal perfusion pressure breakthrough theory. Clin Neurosurg. 1978;25:651–72.
    1. Stapf C, Mast H, Sciacca RR, Choi JH, Khaw AV, Connolly ES, et al. Predictors of hemorrhage in patients with untreated brain arteriovenous malformation. Neurology. 2006;66:1350–5.
    1. Stapf C, Mohr JP, Pile-Spellman J, Sciacca RR, Hartmann A, Schumacher HC, et al. Concurrent arterial aneurysms in brain arteriovenous malformations with haemorrhagic presentation. J Neurol Neurosurg Psychiatry. 2002;73:294–8.
    1. Steiner L, Leksell L, Greitz T, Forster DM, Backlund EO. Stereotaxic radiosurgery for cerebral arteriovenous malformations. Report of a case. Acta Chir Scand. 1972;138:459–64.
    1. Steiner L, Lindquist C, Adler JR, Torner JC, Alves W, Steiner M. Clinical outcome of radiosurgery for cerebral arteriovenous malformations. J Neurosurg. 1992;77:1–8.
    1. Stiefel MF, Al-Okaili R, Weigele JB, Hurst RW. De novo aneurysm formation and regression after brain arteriovenous malformation embolization: Case report. Surg Neurol. 2007;67:99–101. discussion 101.
    1. Sure U, Butz N, Siegel AM, Mennel HD, Bien S, Bertalanffy H. Treatment-induced neoangiogenesis in cerebral arteriovenous malformations. Clin Neurol Neurosurg. 2001;103:29–32.
    1. Taylor CL, Dutton K, Rappard G, Pride GL, Replogle R, Purdy PD, et al. Complications of preoperative embolization of cerebral arteriovenous malformations. J Neurosurg. 2004;100:810–2.
    1. Turjman F, Massoud TF, Vinuela F, Sayre JW, Guglielmi G, Duckwiler G. Aneurysms related to cerebral arteriovenous malformations: Superselective angiographic assessment in 58 patients. AJNR Am J Neuroradiol. 1994;15:1601–5.
    1. Valavanis A, Yasargil MG. The endovascular treatment of brain arteriovenous malformations. Adv Tech Stand Neurosurg. 1998;24:131–214.
    1. Van Beijnum J, van der Worp HB, Buis DR, Al-Shahi Salman R, Kappelle LJ, Rinkel GJ, et al. Treatment of brain arteriovenous malformations: A systematic review and meta-analysis. JAMA. 2011;306:2011–9.
    1. Veznedaroglu E, Andrews DW, Benitez RP, Downes MB, Werner-Wasik M, Rosenstock J, et al. Fractionated stereotactic radiotherapy for the treatment of large arteriovenous malformations with or without previous partial embolization. Neurosurgery. 2008;62(Suppl 2):S763–75.
    1. Vinters HV, Lundie MJ, Kaufmann JC. Long-term pathological follow-up of cerebral arteriovenous malformations treated by embolization with bucrylate. N Engl J Med. 1986;314:477–83.
    1. Vinuela F, Dion JE, Duckwiler G, Martin NA, Lylyk P, Fox A, et al. Combined endovascular embolization and surgery in the management of cerebral arteriovenous malformations: Experience with 101 cases. J Neurosurg. 1991;75:856–64.
    1. Vinuela F, Duckwiler G, Guglielmi G. Contribution of interventional neuroradiology in the therapeutic management of brain arteriovenous malformations. J Stroke Cerebrovasc Dis. 1997;6:268–71.
    1. Waltimo O. The change in size of intracranial arteriovenous malformations. J Neurol Sci. 1973;19:21–7.
    1. Weber W, Kis B, Siekmann R, Jans P, Laumer R, Kuhne D. Preoperative embolization of intracranial arteriovenous malformations with Onyx. Neurosurgery. 2007;61:244–52. discussion 252-4.
    1. Wikholm G, Lundqvist C, Svendsen P. Embolization of cerebral arteriovenous malformations: Part I--Technique, morphology, and complications. Neurosurgery. 1996;39:448–57. discussion 457-9.
    1. Yahara K, Inagawa T, Tokuda Y, Takechi A, Shibukawa M, Inokuchi F, et al. [A case of multiple cerebral arteriovenous malformations treated by gamma knife radiosurgery] No Shinkei Geka. 1995;23:1121–5.
    1. Yamamoto M, Jimbo M, Hara M, Saito I, Mori K. Gamma knife radiosurgery for arteriovenous malformations: Long-term follow-up results focusing on complications occurring more than 5 years after irradiation. Neurosurgery. 1996;38:906–14.
    1. Yamamoto M, Jimbo M, Ide M, Tanaka N, Lindquist C, Steiner L. Long-term follow-up of radiosurgically treated arteriovenous malformations in children: Report of nine cases. Surg Neurol. 1992;38:95–100.
    1. Yamamoto M, Jimbo M, Kobayashi M, Toyoda C, Ide M, Tanaka N, et al. Long-term results of radiosurgery for arteriovenous malformation: Neurodiagnostic imaging and histological studies of angiographically confirmed nidus obliteration. Surg Neurol. 1992;37:219–30.
    1. Yashar P, Amar AP, Giannotta SL, Yu C, Pagnini PG, Liu CY, et al. Cerebral arteriovenous malformations: Issues of the interplay between stereotactic radiosurgery and endovascular surgical therapy. World Neurosurg. 2011;75:638–47.
    1. Yen CP, Steiner L. Gamma knife surgery for brainstem arteriovenous malformations. World Neurosurg. 2011;76:87–95. discussion 57-8.
    1. Yu SC, Chan MS, Lam JM, Tam PH, Poon WS. Complete obliteration of intracranial arteriovenous malformation with endovascular cyanoacrylate embolization: Initial success and rate of permanent cure. AJNR Am J Neuroradiol. 2004;25:1139–43.
    1. Yuki I, Kim RH, Duckwiler G, Jahan R, Tateshima S, Gonzalez N, et al. Treatment of brain arteriovenous malformations with high-flow arteriovenous fistulas: Risk and complications associated with endovascular embolization in multimodality treatment. Clinical article. J Neurosurg. 2010;113:715–22.
    1. Zabel-du Bois A, Milker-Zabel S, Huber P, Schlegel W, Debus J. Risk of hemorrhage and obliteration rates of LINAC-based radiosurgery for cerebral arteriovenous malformations treated after prior partial embolization. Int J Radiat Oncol Biol Phys. 2007;68:999–1003.
    1. Zipfel GJ, Bradshaw P, Bova FJ, Friedman WA. Do the morphological characteristics of arteriovenous malformations affect the results of radiosurgery? J Neurosurg. 2004;101:393–401.

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