Arteriovenous Malformations (AVMs)
Arteriovenous malformations (AVMs) — abnormal tangles of arteries and veins — are complex lesions that require specialized care. At NewYork-Presbyterian Hudson Valley Hospital, board-certified interventional radiologists from ColumbiaDoctors, the faculty practice of NewYork-Presbyterian/Columbia University Irving Medical Center, treat AVMs with embolization, a minimally invasive, safe, and highly effective treatment for AVMs, allowing patients to quickly return to a quality of life.
What are Arteriovenous Malformations (AVMs)?
Arteriovenous malformations (AVMs) are abnormal blood vessels that involve both the arteries and veins. Some AVMs prevent oxygenated blood from filling capillaries, the tiny blood vessels that connect the arteries and veins. In a potentially dangerous form of AVM, blood travels directly from the arteries into the veins without ever reaching the capillary system, depriving tissues of oxygen. If you have been diagnosed with an AVM, your physician may refer you to an interventional radiologist for a procedure called embolization.
What is Embolization?
Embolization is a minimally invasive procedure in which blood vessels that supply the AVM are blocked. Using imaging guidance, the interventional radiologist passes a catheter from a small opening in the groin to the malformation, injects a contrast dye to highlight the blood vessels and malformation, and blocks the artery with a synthetic material called an “embolic agent”. By stopping the flow of blood to and through the malformation, your doctor can shrink it, minimize the risk of hemorrhage, and stop symptoms from progressing.
How do I get ready for the procedure?
On the night before the procedure, eat a light meal and then do not eat or drink anything after midnight. Your doctor will provide more details about which medications you can take in the days before and on the morning of the procedure. Plan to have someone accompany you home after the procedure. Occasionally, patients are admitted overnight for additional monitoring.
What will happen during the procedure?
After you arrive at the interventional radiology (IR) suite and change into a gown, you will lie face-up on the procedure table. You’ll receive a combination of medicines called “conscious sedation” intravenously to help ease any pain and discomfort. Using X-ray and/or ultrasound image guidance, we’ll insert a long, very thin tube called a catheter through a small incision into a large blood vessel in the groin, arm, or neck. The doctor will inject a contrast dye through the catheter to highlight the malformation and the blood vessels that supply it on the X-ray, and will then deliver a synthetic material called an “embolic agent” to block the artery. The embolic agent used most often is a metallic coil. Once it is confirmed that there is no flow going to the AVM, the catheter is removed, and a band-aid is placed at the groin. The procedure takes about one hour.
Are there any risks?
In general, interventional therapy is safe and commonly associated with only minor side effects, including low-grade fever, nausea, and pain. The most serious risk is that an interventional procedure may cause hemorrhage or bleeding.
After the procedure
After your AVM is treated, you’ll be monitored in our recovery room for several hours. In most cases, patients are discharged in the late afternoon following their procedure. Most patients report mild chest pain for several days after the procedure. This is normal and goes away with over-the-counter pain medications. Patients typically resume normal activities soon after leaving the hospital. Some patients even report higher energy levels after the AVM is treated.
Why Choose Us
World-Class interventional radiology expertise
We offer unmatched expertise in the latest minimally invasive, image-guided procedures to diagnose and treat even the most complex cases. In addition to caring for patients, our experts are involved in educating residents, fellows, and medical students and in a wide range of research endeavors. Our interventional radiologists frequently collaborate with specialists throughout the NewYork-Presbyterian healthcare network, placing them at the forefront of advanced medical imaging and minimally invasive treatments.
At NewYork-Presbyterian Hudson Valley Hospital, we are committed to incorporating the latest cutting-edge imaging technologies into your care, including X-ray fluoroscopy, computer tomography (CT), magnetic resonance imaging (MRI), and ultrasound. Each new generation of equipment provides better outcomes and reduces the patient’s exposure to radiation.
Book a Radiology Appointment With us
Patients can book Radiology appointments online via NYP.org/Connect as long as the patient has an Epic Order. Radiology appointments for X-Ray, ultrasound, bone density, echocardiogram, and limited CT and MRI scans.