J Neurosurg Sci
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Since the first landmark randomized trials on unruptured bAVMs were published, there has been emerging concerns about the role of endovascular therapy. For bAVMs considered inoperable, embolization remains an option worth considering, especially in young patients presenting with a rupture. We aimed to review the curative potential of contemporary stand-alone embolization techniques enabling high occlusion rates and their respective short and long term safety profile. ⋯ Stand-alone curative embolization, as well as exclusive microsurgery or radiosurgery each play complementary roles. Hemorrhagic, deep-seated lesions are an interesting subtype of surgically unfavorable bAVMs that may benefit from exclusive transvenous embolization, when carefully selected. Larger randomized trials and prospective registries are needed to establish the place of stand-alone or neoadjuvant endovascular treatment.