AVM Compartments: Do they modulate trasnidal pressures? An electrical network analysis

Abstract

Background:Arteriovenous malformation (AVM) compartments are thought as independently fed, hemodynamically independent components of the AVM nidus. Its possible role in modulating transnidal pressures have not been investigated to our knowledge.Objective:To investigate if AVM compartments play a role in modulating transnidal pressures by using electrical models as a method of investigation.Materials and Methods:Monocompartmental and multicompartmental AVM models were constructed using electrical circuits- building on Dr. Guglielmi's previous work. Each compartment was fed by two feeding arteries (resistors) and had a shared draining vein with other compartments in the AVM nidus. Each compartment is composed of a series of resistors which represents the pressure gradient along the AVM (arterial, arteriolar, venular, and venous). Pressure (voltage) readings were obtained within these nidal points.Results:The pressure gradient (venous-arterial) is more as there are less AVM compartments in the nidus model. The monocomparmental model had a pressure gradient of 66mmHg (V); while it was 64, 61, and 59 for the 2-, 3-, and 4-compartment models, respectively. In addition, the more the number of compartments, the greater the flow (mA) is in the whole AVM nidus, 33 ml/min for the monocompartmental AVM and 121ml/min for the 4-compartment AVM; though there was greater flow per compartment as there were less compartments, 33ml/min per compartment for the monocompartmental model versus 29ml/min for the 4-compartment model.Conclusion:Transnidal pressure gradients may be less the more compartments an AVM has. This electrical model represents an approach that can be used in investigating the hemodynamic contributions of AVM compartments.