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Arteriovenous Malformation Repair: What you need to know

Arteriovenous Malformations (AVMs) occur when a group of vessels in the body form incorrectly, generating an abnormal connection between arteries and veins. These vessels tangle unusually and form direct connections, bypassing normal tissues. Mostly, AVM is a congenital malformation, but it can be detected in adults too.

Initially, symptoms associated with AVM are hard to diagnose; it may cause headaches or seizures in some people. An AVM that has not burst does not possess early signs but can be discovered in other medical examinations conducted during unrelated health issues. However, a ruptured AVM can cause leakage in blood vessels leading to stroke, swelling in the brain, or cardiac arrest. In such conditions, a person needs immediate medical attention.

Symptoms of AVM

Usually, symptoms of AVM are detected based on the precise location of the malformation. According to doctors, AVM carries a higher risk of bleeding, causing severe damage to the organs. As a person grows older, mostly during puberty or pregnancy, and if anybody had a severe injury,AVM can get bigger. The patient’s life is at risk with other health concerns, including pain, ulcers, haemorrhage or even stroke or heart attack.

Some physical symptoms associated with AVM are:

•           Headache

•           Back pain

•           Seizures

•           Loss of sensation in some parts of the body

•           Buzzing sound in the ears

•           Dizziness

•           Muscle Weakness

•           Facial Paralysis

•           Trouble in speaking, understanding and vision 

Treatment

Treatment for AVMis determined based on the abnormality, signs, symptoms, discomfort, the patient’s overall health, and the risks associated. Firstly, AVM is monitored using imaging tests such as MRI, MRA, CT Scan or Cerebral Angiography to determine the severity of the condition and re-occurring changes. A specialist will decide the best possible treatment after performing a critical examination and determining factors if AVM has already bled or the part of the brain, which can be treated without the risk of damage.

Medication

Medicines will help in controlling the primary symptoms, including headaches, back pain and seizures.

Surgery

AVM is treated depending on its location, size, and how it affects the patient. Mainly surgery is considered the most appropriate approach for treating patients with AVM, especially if there is a high risk of bleeding. In some cases, surgery may help eradicate AVM completely. Embolization and sclerotherapy are the two most common treatments for AVM.

•           Embolization- In this procedure, a catheter is inserted through a blood vessel to permanently block the blood flow (arteries), feeding the AVM with synthetic materials such as metal coils, medical glue or plugs. An AVM starts to shrink in size when the blood flow stops passing through it.

•           Sclerotherapy- In this procedure, a patient is injected with liquid medicine (sclerosant), destroying the vessels leading to less or no blood flow, passing through the AVM. The surgeon will use X-ray imaging or ultrasound scan to pinpoint the exact location of AVM. Sclerotherapy is applied to treat other vascular malformations, including lymphatic malformation or venous malformation.

In AVM management, embolization and sclerotherapy often reduce the symptoms and ease the condition. However, these methods don’t fully cure AVM but limit its growth. Many patients undergo these treatments several times throughout their lifetime. 

Follow-Up

Regular follow-ups with the doctor are an important part of the treatment of AVM. Your doctor will continue to take imaging tests to ensure the condition is resolved and the risk of relapse is not likely to occur. 

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