Have you or someone you know been diagnosed with an arteriovenous (AV) malformation? The name of the condition is a mouthful, but it can be explained relatively simply. The tissues of your body, such as your heart, brain and muscles, need oxygen to function properly. Your circulatory system carries oxygen-rich blood in the arterial system, which drops off the oxygen in tiny vessels within a capillary bed. The blood, now oxygen-poor, leaves the capillary bed and returns through the venous system to pick up more oxygen.
When an AV malformation is present, the arterial system is connected directly to the venous system through a mesh or tangle of vessels, rather than via a capillary bed. The result is twofold. The surrounding tissues do not receive as much oxygen as they should, and the pressure of the venous system increases, sometimes to dangerous levels. This excess pressure could lead to a rupture or bleeding of the blood vessel, which is why your physician has likely recommended that you undergo AV malformation treatment.
There are multiple treatment options available to you in the New Jersey area, and your surgeon will recommend what they feel is most appropriate based upon the location of your AV malformation, its severity and your personal health history.
Option 1: Embolization
Embolization is the injection of a special, glue-like material to block off the blood vessels at the site of the malformation, preventing blood from flowing through the area. Your physician may recommend embolization if he or she feels it could successfully resolve your AV malformation, or they may recommend it prior to operating on the malformation directly.
The procedure itself involves your surgeon making an incision near the groin, at the upper inner thigh, and inserting a catheter into the artery there. They will then use an imaging-guided system to direct the catheter to the area of the AV malformation. Once it is in place, they will inject the embolizing agent, in this case a kind of glue, which will fill in and block the malformed vessels.
After this type of AV malformation treatment, you can expect to spend a couple of days in the hospital. Of course, because patients are individual, so are recovery times. However, the only incision site that requires healing is relatively small and will not extensively limit activity.
Option 2: Microsurgical Resection
Sometimes the cerebrovascular neurosurgeon will need to access the site directly to perform your AV malformation treatment. If that is the case, they will perform what is called a microsurgical resection. Microsurgery is an advanced technique which uses a microscope, allowing surgeons to perform delicate procedures. Resection means the surgeon will surgically modify the blood vessels themselves, resolving the misdirected blood flow.
In cases where the AVM is located in the brain, the brain surgeon will need to perform a craniotomy. That means they will need to remove a small section of the skull in order to have direct access to the surgical site. A craniotomy may also be done as a final step to remove the AVM after embolization has been performed. In that case, embolization serves as an adjuvant to reduce blood flow and thus making the microsurgical resection less bloody.
Because of the more invasive nature of microsurgical resection, your recovery time may be longer, and you can expect to spend about a week in the hospital. Again, this varies depending upon your particular condition and circumstances, and your physician can give you a better idea of what exactly to expect after your surgery.
Option 3: Stereotactic Radiosurgery
Not all patients will be candidates for microsurgical resection because of medical complications, or the AV malformation may be too difficult to reach. In these cases, there is a third AV malformation treatment option, called stereotactic radiosurgery. The process is called surgery, but there is no actual incision involved, which makes it ideal for some patients whose health status rules out the option of traditional surgery.
Stereotactic techniques use three-dimensional imaging to guide the surgeon to the location of the AV malformation. They use a focused beam of radiation directly on the site to disrupt the DNA of the blood vessels which causes them to ultimately close off and prevent blood from flowing through the site. It typically takes one treatment to achieve desired results, but it may take years until the AVM resolves and is considered fully treated. In some situation, it may not be advisable to wait for that long. Hence, there are pros and cons to every treatment option.
The Right Treatment for You
Regardless of the specifics of your condition and health status, you have options available for your AV malformation treatment, and your physician can help you determine which is best for you. There are cerebrovascular neurosurgeons in the New Jersey area who specialize in each surgery, and they can provide you with the highest level of care, tailored to your individual needs.
If you have any questions or concerns about your upcoming surgery, be sure to express them with your care team. Your physician and your surgeon will work with you to develop a treatment plan with the best potential outcome for your case. There are specialists in the New Jersey area who have experience in AV malformation treatment using state-of-the-art technology, and they will work with you to ensure you receive the best possible care before, during and after your procedure.
