How We Treat Arteriovenous Malformations
How Are AVMs Treated?
AVMs interfere with normal blood flow through the brain, but not all AVMs need to be treated. If you have an AVM, we may watch it (using imaging tests) to make sure it doesn’t change and become dangerous (since some AVMs can contribute to seizures or bleeding in the brain). How do we decide whether you need treatment? Our decision depends on:
- Your overall health
- The location and size of the AVM in your brain or spine
- The risks of any complications, with or without treatment.
If you do need treatment for your AVM, our goal is to treat it using noninvasive or minimally invasive methods while reducing your risk of future problems. Your treatment may include:
- Stereotactic radiosurgery: We use precisely targeted radiation to destroy your AVM without entering your skull. The radiation causes the blood vessels in the AVM to clot slowly during the months or years after your treatment. This noninvasive therapy works best if you have a small AVM or an AVM that has not already caused considerable bleeding.
- Microsurgery: Sometimes we need to enter the skull through a small opening to remove the abnormal vessels in the AVM. After this minimally invasive surgery, we closely monitor you to make sure your blood pressure is carefully controlled. Then we use a high-quality angiogram, a special x-ray that shows your blood vessels, to make sure that your AVM has been completely removed.
- Endovascular embolization: We insert a catheter into a leg artery and thread it through your body until it reaches the AVM. Then we inject small particles of a glue-like substance to block the vessel and reduce the blood flow to your AVM. Embolization also plays a role in making surgery safer and is used to treat certain high-risk features of an AVM in a minimally invasive manner. Embolization may redirect blood flow back to your normal brain tissue and reduce any stroke-like symptoms you may have been having (such as difficulty speaking or numbness on one side of your body).