Técnica microquirúrgica para resección de malformaciones arteriovenosas

The arteriovenous malformations of the brain (AVMs), are the most commonly recognized of the vascular malformations because of their clinical and therapeutical implications. Even when there are many papers in the literature about the surgical technique, most of them lack of a detailed and systematic description of the microtechnique. This point is a matter of concern specially for young neurosurgeons in training, because only a few neurosurgical centers have enough number of patients with AVMs to get a theoretical and practical concept to deal with such a cases. In this work, it is presented a detailed description of the microsurgical technique based on the acronym “ACADEV”. This acronym includes all the steps necessaries to assure an effective treatment of an AVM as follows: A= angioarchitecture, C=craniotomy, A=attack (peripheral attack), D=dissection (circumferencial), E=extensive coagulation of feeders and, V= vein(s) of drainage. In addition, a special remarks are made about our surgical results, the proper surgical intrumentation and another special tips according to the surgical experience of the author.