Arteriovenous Malformations (AVM) Treatment

AVMs consist of an abnormal tangle of blood vessels in the brain or spinal cord where arteries drain directly into veins without an intervening capillary bed. Patients typically present with seizures or bleeding into or around the brain.

The risks and decision to treat an cerebral AVM depends on a number of variable factors. These include whether the AVM has bled, whether the AVM is near to or involving very important brain structures and how large the AVM is.

There are several possible treatments for AVM’s. These include embolisation which is performed by our group of specialists, neurosurgery or radiotherapy. Sometimes we combine 2 or more of these techniques to treat an AVM in the safest way possible.

The risk of AVM treatment includes potentially causing a bleed from the AVM or a stroke by blocking normal vessels. Such bleeding or strokes can be severe and even result in death.

The risks of treatment vary greatly from patient to patient. Some smaller AVM’s can be treated with risks of around 2-3% however some of the more difficult AVMs’ carry treatment risks up to 40%.
Embolisation is a technique of blocking the abnormal vessels with small particles or a glue type substance. This procedure is performed under general anaesthesia. A small tube or catheter is introduced into an artery in the groin and passed all the way into the arteries supplying the AVM. The adhesive is then injected and the injection is monitored by xrays. These procedures typically take 2 to 3 hours. On some occasions several embolisation sessions are required.

Embolisation can be performed to cure small AVM’s or as a preoperative procedure to reduce the risks of neurosurgery.

Our doctors work with the neurosurgeons and make decisions about the safest way to treat these lesions in consultation with the surgeons.

AVM treatment is improving as medical technology improves but they remain difficult lesions to manage. The treatment of some AVM’s may carry too high a risk and some patients may be better off not having any form of surgery.

The risks and benefits vary from person to person and our doctors are happy to discuss various treatment options, particularly whether embolisation may be an option for their AVM.