Arteriovenous Malformations in Five Dimensions

摘要

Arteriovenous malformations (AVMs) are vascular lesions associated with abnormal arteries and veins that connect with each other directly instead of connecting through an intervening capillary network (1). The result is that blood at high pressure goes from the thick-walled artery through a shunt directly into the thin-walled vein, resulting in hemodynamic stress on the shunt and venous vessel. The increased blood flow in an AVM weakens the blood vessels, potentially resulting in a dangerous rupture. Several vascular diseases exhibit these abnormal AVMs, including hereditary hemorrhagic telangiectasias and aneu-rysms. AVMs in the brain are particularly difficult to treat, and their rupture may result in stroke or death. Although AVMs can be visualized in human patients (J), elucidating how and why they form has proved challenging. An exciting study by Murphy, Wang, and colleagues in this issue of Science Translational Medicine (2) describes experimentally induced regression of AVMs in mice with stunning visual and molecular clarity, with clear implications for both the clinician and the scientist.