Management of arteriovenous malformations: a surgical perspective.

The management strategies for arteriovenous malformations (AVMs) continue to evolve, spurred by advancing technology and improved understanding of the natural history of these lesions. In general, intervention is reserved for Spetzler-Martin Grade I-III lesions or for those with certain high-risk features. Grade IV-V AVMs, in contrast, are usually managed conservatively. Although multimodality therapy incorporating endovascular and/or radiosurgical techniques is increasingly common, microsurgical removal remains the definitive form of treatment.