Vascular endothelial growth factor blockade: A potential new therapy in the management of cerebral arteriovenous malformations

摘要: Abstract Cerebral arteriovenous malformations (AVMs) occur universally in 1.1 per 100,000 people. These are the cause of serious neurological morbidity or even death when they bleed. AVMs not necessarily static congenital abnormalities. They can undergo internal changes due to angiogenesis resulting vascular remodelling. regrow after successful therapy. Vascular endothelial growth factors (VEGFs) play an important role angiogenesis. Drugs that block action VEGF on factor receptors (VEGFRs) cell surface available. This blockade causes anti-angiogenetic effect. Anti-angiogenic drugs widely used as adjuvant therapy management cancers because suppress formation new blood vessels required by tumour for growth. For similar reasons, treatment age-related macular degeneration. The present options surgery, embolisation and irradiation either their own combination. Irradiation with stereotactic radiosurgery (SRS) offers advantage being non-invasive, but it relies late radiation effects achieve its therapeutic goal complete obliteration. latent time (1–3 years), during which risk a bleed remains, is inherent drawback SRS. histopathology surgical specimens post-SRS demonstrates cells repairing damage. Suppressing activity post SRS has potential enhance damage hence speed up obliteration process reduce time. It postulated such ‘VEGF blockade’ could be useful In addition, there also neo-adjuvant use, whereby regression size AVM, making definite easier. rationale VEGF-blockade concept presented discussed.