Journal of Vascular Medicine & Surgery

Vascular endothelial growth factor blockade: A potential new therapy in the management of cerebral arteriovenous malformations

World Congress on Vascular Diseases, Medicine & Surgeons Summit

October 24-25, 2016 Chicago, USA

Frederik Vernimmen

Cork University Hospital, Ireland

Posters & Accepted Abstracts: Vasc Med Surg

Abstract:

Cerebral Arterio Venous Malformations (AVM) occurs universally in 1.1 per 100000 people. They are the cause of serious neurological morbidity or even death when they bleed. AVM�??s are not necessarily static congenital abnormalities. They can undergo internal changes due to angiogenesis resulting in vascular remodeling. They can even re-grow after successful therapy. Vascular endothelial growth factors (VEGF) play an important role in angiogenesis. Drugs are available that block the action of VEGF on VEGFR receptors on the endothelial cell surface. This blockade causes an anti-angiogenetic effect. Antiangiogenic drugs are widely used as adjuvant therapy in the management of cancers because they suppress the formation of new blood vessels required by the tumor for growth. For similar reasons they are used in the treatment of age related macular degeneration. The present treatment options for AVM�??s are surgery, embolization and irradiation either on their own or in combination. Irradiation with Stereotactic Radiosurgery (SRS) offers the advantage of being non invasive, but relies on the late radiation effects to achieve its therapeutic goal of complete obliteration. This latent time (1-3 years) during which the risk for a bleed remains is an inherent drawback of SRS. The histopathology of surgical specimens of post SRS AVM�??s demonstrates a role of endothelial cells in repairing the radiation damage. Suppressing their activity post SRS by a VEGF Blockade has the potential to enhance the radiation damage and hence speed up the obliteration process and reduce the latent time. It is postulated that such a �??VEGF Blockade�?� could be useful as an adjuvant therapy to SRS. In addition there is the potential for a neo adjuvant use, whereby a VEGF blockade could cause regression in the size of the AVM, making definite therapy easier. The rationale for the VEGF-blockade concept will be presented and discussed.

Biography :

Email: Frederik.Vernimmen@hse.ie