In managing AVMs, when should treatment with embolization typically be initiated?

• A. When asymptomatic
• B. Upon detecting symptoms
• C. Immediately after diagnosis
• D. Only if surgical options are unavailable

Answer: (B)

Treatment with embolization for arteriovenous malformations (AVMs) is typically initiated upon detecting symptoms. Symptomatic AVMs can lead to various complications, including bleeding, ischemia, or neurological deficits, depending on their location and size. As a result, when symptoms arise, they indicate that the AVM may be compromising the normal function of surrounding tissues and necessitate intervention to prevent further complications.

In instances where a patient presents with symptoms, prompt treatment through embolization can alleviate these issues by reducing blood flow to the AVM, thereby minimizing the risk of hemorrhage and addressing any functional deficits the malformation may cause. This approach ensures that the immediate health concerns associated with the AVM are addressed effectively.

In cases where the AVM is asymptomatic, monitoring may be considered as the management strategy, and immediate intervention may not be necessary. Additionally, while diagnosis of an AVM is an important step, immediate treatment without symptoms is not the standard practice. Lastly, relying solely on the availability of surgical options does not provide a comprehensive approach to AVM management, as embolization may be warranted based on symptomatic presentation irrespective of other surgical considerations.