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Brief Title: Transvenous Approach for the Treatment of Cerebral Arteriovenous Malformations
Official Title: Transvenous Approach for the Treatment of Cerebral Arteriovenous Malformations (TATAM): A Randomized Controlled Trial and Registry
Study ID: NCT03691870
Brief Summary: A new endovascular route for the treatment of brain AVMs may be possible in some cases: Trans-Venous Embolization (TVE). The technique uses microcatheters to navigate to the draining veins of AVM, to reach and then fill the AVM nidus retrogradely with liquid embolic agents until the lesion is occluded. This technique has the potential to improve on some of the problems with the arterial approach to AVM embolization, such as a low overall occlusion rate. However, by occluding the vein first, and filling the lesion with the embolic agent in a retrograde fashion, the method transgresses a widely held dogma in the surgical or endovascular treatment of AVMs: to preserve the draining vein until all afferent vessels have been occluded. Nevertheless, the initial case series have shown promising results, with high occlusion rates, and few technical complications. The method is increasingly used in an increasing number of centers, but there is currently no research protocol to guide the use of this promising but still experimental treatment in a prudent fashion. Care trials can be designed to offer such an experimental treatment, taking into account the best medical interests of patients, in the presence of rapidly evolving indications and techniques.
Detailed Description:
Minimum Age:
Eligible Ages: CHILD, ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
University of Alberta Hospital, Edmonton, Alberta, Canada
Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada
Centre hospitalier universitaire de Bordeaux, Bordeaux, , France
Centre hospitalier régional universitaire de Brest, Brest, , France
Centre hospitalier universitaire de Grenoble, Grenoble, , France
Centre hospitalier universitaire Limoges, Limoges, , France
Hôpital Forndation Adolphe de Rothschild, Paris, , France
Centre hospitalier universitaire de Rouen Normandie, Rouen, , France
Centre hospitalier universitaire de la Réunion, Saint-Paul, , France