The AVM neuroendovascular grade and the Buffalo score have been proposed to specifically predict the risk of clinical complications associated with brain AVM embolization.

To develop and validate a new radio-clinical grading system that helps to determine which patient should be treated by transarterial AVM embolization.

The proposed radio-clinical grading system was retrospectively applied to 170 consecutive brain AVM cases embolized transarterially between 2015 and 2018. The scoring system was based on data published before.

Among 170 AVMs, 117 AVMs were embolized transarterially, complete occlusion was obtained in 71 (60.7%) cases. Three (2.6%) feeding artery perforation complications were encountered in 3 cases without causing any neurological deficits. The AVM grading system can be used to evaluate patient selection and results of endovascular embolization (p < 0.001). Patients with an AVM grade higher than 3 can be treated endovascularly compared to patients with an AVM of grade 2 or lower.

The radio-clinical grading system could be used to determine which brain AVM should be treated by transarterial embolization. Further testing of this scheme for complication or cure rate using prospective methodology is still required.