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Neurology and Neuroscience

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State-of-the-art technological advances used at NewYork-Presbyterian Hospital enable our team to treat arteriovenous malformations (AVMs) with great success, using surgical, endovascular, and radiosurgical approaches. The decision to treat a brain AVM depends on its location, the risk of future complications if left untreated, and the potential side effects of treatment.

scan of arteriovenous malformation before and after surgery
Angiography of an arteriovenous malformation before (left) and after (right) surgical treatment.

There are a number of surgical techniques, which may be used in combination, for the treatment of AVMs:

  • Stereotactic radiosurgery: Our highly skilled neurosurgeons use precisely targeted radiation to destroy the AVM, without entering the skull. The radiation causes the AVM vessels to slowly clot in the months or years following the treatment. This treatment works best for small AVMs and for those that have not caused a life-threatening hemorrhage.
  • Microsurgical resection of the AVM: Surgeons enter the skull to remove the abnormal vessels found in the AVM. Following this procedure, close monitoring and strict control of blood pressure are required. Doctors use a high-quality angiogram to ensure that the AVM has been completely removed.
  • Endovascular embolization: Doctors insert a catheter into a leg artery and thread it through the body to the affected brain arteries. Small particles of a glue-like substance are injected to block the vessel and reduce blood flow to the AVM. Embolization is often used before surgery and may reduce the size of a large AVM enough to avoid surgery, making radiosurgery an option. In some patients with large brain AVMs, endovascular embolization may reduce stroke-like symptoms by redirecting blood flow back to normal brain tissue.

NewYork-Presbyterian researchers are seeking new, more effective ways to treat arteriovenous malformations. Patients have access to clinical trials of innovative approaches.

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