Gilbert Patrick, Dubois Josée, Giroux Marie France, Soulez Gilles
Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, Quebec, Canada.
Department of Radiology, Centre Hospitalier Universitaire Ste Justine, Université de Montréal, Montreal, Quebec, Canada.
Semin Intervent Radiol. 2017 Sep;34(3):258-271. doi: 10.1055/s-0037-1604299. Epub 2017 Sep 11.
Arteriovenous malformations (AVMs) are high-flow vascular anomalies that have demonstrated a very high recurrence rate after endovascular treatment, surgical treatment, or a combination of both. Surgical treatments have shown good response when they are small and well localized but a poor response when diffuse. A better understanding of the nature of the lesion has led to a better response rate and a safer treatment for these patients. This has been accomplished through a detailed understanding of the angioarchitecture of the lesion, enabling a tailored approach in reaching and targeting the nidus of the AVM with different liquid embolic agents, more specifically ethanol. Flow reduction techniques help in exposing the nidus to sclerosant agents. A clinical classification, the Schobinger classification, will help determine the appropriate time to start or to pursue therapy.
动静脉畸形（AVM）是高流量血管异常，在血管内治疗、手术治疗或两者联合治疗后，其复发率非常高。手术治疗在病变较小且定位良好时显示出良好的效果，但在病变弥漫时效果不佳。对病变性质的更好理解已为这些患者带来了更高的缓解率和更安全的治疗。这是通过对病变血管结构的详细了解实现的，从而能够采用定制方法，使用不同的液体栓塞剂，更具体地说是乙醇，到达并靶向AVM的病灶。血流减少技术有助于使病灶暴露于硬化剂。一种临床分类方法，即朔宾格分类法，将有助于确定开始或继续治疗的合适时机。
