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Letters to the Editor
Arteriovenous malformation embocure score (AVMES): reply
  1. Stephan A Munich,
  2. Demetrius K Lopes
  1. Neurosurgery, Rush University Medical Center, Chicago, Illinois, USA
  1. Correspondence to Dr Stephan A Munich, Neurosurgery, Rush University Medical Center, 1725 West Harrison St, Suite 855, Chicago, IL 60612, USA; Stephan.Munich{at}gmail.com

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We greatly appreciate the authors’ interest and review of our paper and congratulate them on the recent publication of their endovascular arteriovenous malformation (AVM) grading scale. The addition of their study to the previously published Buffalo score1 and our arteriovenous malformation embocure score (AVMES) enriches this new domain of neuroendovascular surgery, but also serves to highlight the need for such a tool. We appreciate the authors’ experience and opinions articulated in their review of our paper.

The authors raise the issue of redundancy between the factors of size and arterial feeders. They draw on their own experience, which demonstrated a correlation between the nidal size and the number of arterial pedicles. We chose to consider these factors separately for three reasons. First, though common, this association does not always hold true. Two, the number of arterial pedicles is often reflective of the qualitative complexity of the AVM, with a lesion harboring more arterial pedicles generally being considered more complex. By including the number …

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