Endovascular embolization in combination with radiosurgery for treatment of arteriovenous malformations.

There are several options for the treatment of patients with arteriovenous malformations (AVMs). Surgical resection, radiosurgery and endovascular embolization can be used alone or in conjunction. In patients with AVMs not amenable to surgical resection due to large size or location, radiosurgery can address some but not all of these issues as cure rates remain low for volumes >10 cm3. Combining endovascular embolization with stereotactic radiosurgery allows potential volume reduction and reduction of risks related to factors that may increase bleeding risks during the latency interval after radiosurgery. The benefit of increased cure rates and possibly lower hemorrhage rates in the latency period may justify the added risk of embolization.