Introduction We present a case study of a 32-year-old female patient admitted with an intracerebral hematoma detected on brain CT, subsequently diagnosed with an arteriovenous malformation (AVM) through CT angiography. A pivotal question arose regarding the optimal approach – arterial or venous – for intervention.

Case Description Upon careful consideration, the decision was made to pursue a venous approach. Specifically, the procedure involved initial access via the femoral vein followed by advancement to the cervical venous system. This approach was chosen based on several factors, including the AVM’s location, vascular anatomy, and the potential for minimizing procedural risks while optimizing therapeutic efficacy.

This case study was presented to highlight the nuanced decision-making process involved in AVM management. The choice of a venous approach was informed by a multidisciplinary team comprising neurosurgeons, interventional neuroradiologists, and neurologists, who collectively weighed the risks and benefits to tailor the intervention to the patient‘s specific clinical scenario.

Results This case underscores the importance of individualized treatment strategies in neurointervention, particularly in complex cases such as AVMs. By sharing this experience valuable insights were exchanged, contributing to the advancement of best practices in AVM management and ultimately improving patient outcomes.

Disclosure of Interest no.