ABSENCE OF AN ANGIOGENIC FACTOR IN LARGE SYSTEMIC ARTERIOVENOUS-MALFORMATIONS

RATIONALE AND OBJECTIVES. Large symptomatic arteriovenous malformation s (AVMs) are currently managed by a combination of surgery, embolizati on, and supportive measures. If patients with such lesions should have a circulating factor responsible for their growth and development, th e evolution of a more rational therapy might be possible. METHODS. To explore this possibility, sera from 14 patients with high-flow systemi c AVMs, widely distributed anatomically, were tested for the presence of a circulating growth factor using an assay already successfully use d to isolate such a factor in diabetics with proliferative retinopathy . RESULTS. None of the patients tested positive for such a factor. CON CLUSIONS. This result, although negative, contributes to our knowledge of the biology of these uncommon but important lesions and leads us t o conclude that, for the forseeable future, embolization is likely to remain the most effective form of treatment for high-flow AVMs.