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Arteriovenous Malformation (AVM)
Arteriovenous Malformation (AVM) is a complex tangle of thin-walled blood vessels that can break more easily than normal, healthy vessels. AVM’s are commonly associated with strokes at younger ages (20 – 40 years old), but the onset of symptoms is usually not as fast as the ones produced by an aneurysm rupture.
Treatments
Embolization for Preoperative or Permanent Occlusion
A procedure involving the insertion of a micro catheter through the femoral artery that is threaded through the arterial network until the tip reaches the site of the abnormal feeding arteries to the AVM. Preoperative embolization or closure of AVMs is acquired through the use of therapeutic liquid embolic agents and coils.
Microsurgery
Depending upon the size and location of the AVM, it can be removed surgically.
Stereotactic Radiosurgery
A non-invasive therapeutic approach, it involves aiming a narrow beam of highly focused radiation directly on the AVM. The high dose of radiation damages the walls of the irregular blood vessels causing them to shrivel up and eventually close off.
Combination Therapies
Treatment of brain AVMs has been greatly enhanced by incorporating a combined modality approach. For example, in patients where embolization is used prior to surgery, the subsequent operation is made significantly easier than if the embolization had not been performed. The operating time can be reduced, as can the intraoperative blood loss during the resection of these lesions. In addition, if the AVM is reduced in size significantly either through surgery or embolization, the lesion may then be treated with stereotactic radiosurgery. Due to the resulting changes in the blood vessel walls, the AVM may be obliterated over the course of 2-3 years.