Brain arteriovenous malformation embolization

What is a brain AVM? 

A brain arteriovenous malformation (AVM) is an abnormal tangle of blood vessels, leading to incorrect connections between arteries and veins in the brain. As a result, blood flow and oxygen circulation is disrupted.

If you have a brain AVM, you should seek medical treatment immediately. This is because over time, AVMs grow in size due to the increase in blood flow, causing the walls of the blood vessels to weaken. In some cases, a weakened blood vessel may burst, resulting in bleeding in the brain, also known as a hemorrhage. This can result in serious, life-threatening conditions such as a stroke. 

What is a brain AVM embolization? 

An embolization refers to a minimally invasive procedure, whereby problematic blood vessels are blocked off and blood flow to the blood vessel is cut off. An embolisation can be used to treat a brain AVM. 

What happens during a brain AVM embolization? 

During a brain AVM embolization, your surgeon will guide a soft hollow tube, known as a catheter, through your femoral artery in your leg, up your blood vessels and until the tip of the catheter reaches your AVM. Your surgeon will then inject a substance into your AVM which will create an artificial clot. This will stop the blood from flowing into the AVM. This process is then repeated for every vessel that leads to the AVM. 

A brain AVM embolization is usually conducted with X-ray guidance. This procedure is typically performed with the patient under general anesthesia. Under general anesthesia, you will be put into a sleep-like state, and you will not be able to move voluntarily or feel any pain. 

What are the benefits of brain AVM embolization? 

Some of the benefits of brain AVM embolization include: 

  • Relatively high success rate. For example, small brain AVMs have a cure rate of 70% [1] 
  • No open surgery 
  • Lower risk of complications at 24.5 percent [2] 
  • Low procedure-related mortality rate at 1.5 percent [2]

What are some possible complications of brain AVM embolization? 

The most common complication of brain AVM embolization is bleeding in the brain (hemorrhage). However, the risk of a hemorrhage is relatively low. A study reports that only around 9.7 percent of patients who underwent a brain AVM embolisation got a hemorrhage [2].  

Other possible complications include:

  • Damage to artery where catheter was inserted
  • Risk of infection at site where catheter was inserted
  • Risk of stroke resulting from a hemorrhage 
  • Anesthetic related complications
  • Death 

What happens after a brain AVM embolization?

After a brain AVM embolization, you will likely spend a few hours in the recovery room, and at the hospital for a day or more depending on your condition. Your doctor will also watch your vital signs, such as your heart rate and breathing to ensure that you are recovering well after your procedure. 

You may experience mild, temporary headaches following the treatment. Your doctor will likely ask you to return to the clinic a few months after your procedure as well. Your doctor may order a follow-up angiogram or MRI scan to see if there are any remaining parts of the AVM. This will determine if any additional embolization is needed. 

If you have any questions regarding brain AVM embolization, do seek clarification with your doctor and find out whether this treatment is suitable for you.

References
bottom
  1. Willinsky, R., Goyal, M., terBrugge, K., Montanera, W., Wallace*, M. G., & Tymianski*, M. (2001). Embolisation of Small (< 3 cm) Brain Arteriovenous Malformations. Interventional Neuroradiology, 7(1), 19–27. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3621456/
  2. Wu, E. M., Ahmadieh, T. Y. E., McDougall, C. M., Aoun, S. G., Mehta, N., Neeley, O. J., Plitt, A., Ban, V. S., Sillero, R., White, J. A., Batjer, H. H., & Welch, B. G. (2019). Embolization of brain arteriovenous malformations with intent to cure: a systematic review. Journal of Neurosurgery, 132(2), 388–399. https://doi.org/10.3171/2018.10.JNS181791
  3. Arteriovenous Malformations and Other Vascular Lesions of the Central Nervous System Fact Sheet | National Institute of Neurological Disorders and Stroke. (2015). Nih.Gov; National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Arteriovenous-Malformation-Fact-Sheet
  4. Embolization Treatment for Arteriovenous Malformations (AVMs) of the Brain and Spinal Cord. (n.d.). Brainavm.Oci.Utoronto.Ca. Retrieved December 22, 2020, from http://brainavm.oci.utoronto.ca/malformations/embo_treat_avm_index.htm