The combined treatment of arteriovenous malformations

Abstract

In arteriovenous malformations (AVM), the tactics and techniques of combined treatment have been worked out adapting surgical and non-surgical methods. The most common combinations include surgery, catheter embolization and ethanol sclero therapy. Strict indications should be followed when choosing the appropriate procedures and timing. The best long-term follow-up results are obtained with the combination of presurgery catheter embolization and surgery. Alcohol sclero therapy has gained an important role in combined treatment. Experience has demonstrated that the indication for catheter embolization in the limbs when distally performed should take into consideration the danger of peripheral necrosis. Correct combination with surgery and/or ethanol sclero therapy may avoid such a complication. © 2009 Springer-Verlag Milan.