Masterclass #9: Do all brain AVMs scare us in the same way? Could this be the "Achilles heel" of the ARUBA study?

Tudor G. JOVIN, Istvan SZIKORA, Vitor MENDES PEREIRA, Jacques MORET, Laurent SPELLE

The ARUBA study concluded that unruptured brain arteriovenous malformations (AVM) should only be treated medically. Were these conclusions limited by the study’s design? Are there cases today where an endovascular approach could prove safe, effective and clinically warranted?

Join Professors Jacques Moret and Laurent Spelle as they illustrate the management of unruptured AVMs through specially chosen cases. With their expert panel, join them as they examine the full range of clinical options, looking beyond medical therapy to endovascular, surgical or radiosurgical approaches.

Consider such points in managing unruptured AVMs as:

• Can treatment change the course of the natural history of the AVM’s evolution?
• What is the risk/benefit balance of these interventions?
• What is the risk of bleeding in an unruptured AVM? 1% per year? 3%? 5% or more?
• Can either the transarterial or transvenous approach be used in treating AVMs?
• Are intranidal aneurysms more dangerous than flow-related aneurysms?
• Have advances in devices and imaging technology offer us capabilities that did not exist when the ARUBA study was published?