Stroke & Cerebrovascular Center
Arteriovenous Malformations (AVMs)
ARUBA Study: A Randomized Multicenter Clinical Trial of
Unruptured Brain AVMs
Summary: An arteriovenous malformation (AVM) is a tangled bundle of abnormal arteries and veins that are directly connected to each other. In general, arteries carry fresh oxygen-filled blood from the heart and distribute it through fine and finer vessels (arterioles and capillaries) to all parts of the body to nourish the tissue. Veins bring the "used" blood back to the heart. In the case of an AVM, there is an absence of capillaries and the blood goes directly from an artery into a vein. The main risk of an AVM in the brain is the risk of sudden bleeding if the AVM ruptures. Symptoms might resemble a stroke but also may include headaches or seizures. An AVM that has not bled is called an unruptured AVM. It is not known whether it is better to use one of the available interventional techniques to treat the AVM or to simply follow medically.
Purpose: The purpose of this study is to determine whether it is better to treat an unbled brain arteriovenous malformation (brain AVM) with one or more of several available procedures intended to eliminate the brain AVM or rely on medical therapy to control symptoms.
Mohr JP, Parides MK, Staph C et al. Medical management with or without interventional therapy for unruptured brain arteriovenous malformations (ARUBA): a multicentre, non-blinded, randomised trial. Lancet 2014;383(9917):614-621.