Brain Arteriovenous Shunts

Brain arteriovenous shunts in adults are mainly represented by arteriovenous malformations (AVMs). These are high-flow, low-resistance vascular malformations characterized by the interposition of a tangle of dysplastic vessels, the nidus, fed by arteries and drained by veins; this nidus replaces the normal capillary network. Cerebral AVMs are rare and highly variable in their location, angioarchitecture, and clinical presentation. The most severe mode of presentation is cerebral hemorrhage, which constitutes a diagnostic and therapeutic emergency. The management of AVMs is multidisciplinary, with therapeutic indications discussed based on a risk-benefit analysis, differentiating between ruptured and unruptured AVMs. Endovascular treatment is one of the therapeutic options; current embolization techniques via arterial and/or venous routes and their results will be detailed in this presentation. Advances in understanding the development factors of these AVMs open new perspectives for the development of targeted drug treatments.
René ANXIONNAT, Serge BRACARD, Luc PICARD
University Hospital of Nancy, Lorraine University - France