Arteriovenous Malformations commonly known as AVM is the condition in which blood vessels are abnormally tangled up which results in certain problems like pain due to wrong connected arteries as veins as the name mentions “arteriovenous”.
This is the common problem arising in the brain and spinal cord but other than this it can also occur in any body part.
Introduction AVM Treatment
Before proceeding about this condition, we need to understand what basically happens with arteries and veins functioning.
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The most common working of these blood vessels is to carry oxygenated blood towards the different body parts, organs, cells, tissues, and in return bring back deoxygenated blood to heart.
In this way, blood moves from arteries to capillaries and then towards veins. But in case of AVM condition, blood passes directly from arteries to veins bypassing the capillaries which results in a short circuit of blood flow.
It causes AVM because blood passes through arteries with high pressure whereas it has low pressure while running through veins which might result in abnormal bleeding at the site of abnormal blood vessels connection which then causes certain symptoms like headache, memory loss, weakness, seizures and also certain neurological conditions.
So, there is a high requirement of treating this condition once detected. Factors to be considered for treating this condition:
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- Size and location of AVM: This determines the type of treatment to be carried out as certain parts of the brain are highly sensitive and requires aggressive care while carrying out treatment.
- Symptoms: Depending upon the kind of symptoms the patient is suffering through requires similar care and treatment to alleviate symptoms and avoid future complications.
- Bleeding history
- Age
- Health conditions
- Individual preferences
Treatment of AVM
Certain remedies for treating this condition includes:
Craniotomy
This includes surgical removal of certain sections of the skull with successful removal of AVM. The bone flap is removed to remove a certain skull section and after that this flap is put back in place.
The important factor is to remove abnormal blood vessels without damaging normal brain tissue.
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After surgery, the patient is kept under observation in hospital for an hour and is given medication to treat pain.
Endovascular embolization
- This works by inserting catheter into artery passing through leg and reaching brain by observing through the X-ray machine attached and most importantly the catheter is inserted into that vein which is suffering from AVM and further injects embolizing element or drug solution which is in the form of glue or we can say glue-lie embolizing agent which helps in blocking the artery and decreasing the flow of blood towards AVM affected artery.
Stereotactic radiosurgery (SRS)
As the name suggests, it works by accurately focusing radiation towards AVM blood vessels and destroying them.
Basically, it’s not surgery as there is no use of any surgical instruments and neither any cuts are made on the body.
This kind of surgery is recommended to those who are suffering from small sizes AVM’s and are not treated with the help of old-tradition surgery methods, and is also recommended for those who do not involve the effect of life threatening haemorrhage.
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The main disadvantage of this surgery includes targeting normal functioning blood vessels resulting in scarring.
Radiosurgery with cyber knife
It works by treating AVM with the help of radiation with the help of a cyber knife system.
This system is non-invasive means no insertion of any instruments into the body and also its robotic radiation delivering treatment which works by using real-time imaging which works by delivering correct and safe dose of radiation.
Advantages and disadvantages of treatment
Advantages:
- Improved quality of life by removing symptoms associated with it like headache, seizures and other neurological disorders
- Once treated, it gradually reduces the occurrence of haemorrhage which are fatal for life and not only this but also it is a very important treatment to remove AVM associated with brain and spinal problems.
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- There are multiple treatment options available for treating this condition based on the patient’s health and size and location of AVM and improves patient’s health.
Disadvantages:
- Surgical risks associated with it which includes infection, haemorrhage, certain kind injuries while removing AVM with the help of surgery and also many risks associated while opening the body with cuts.
- Scarring blood vessels due to radiation therapy. Many adverse effects associated with after radiation effects and also embolization related issues.
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- Side effects or adverse effects associated with drugs given for long term monitoring to identify any recurrence of previous or new AVM types.
Advanced therapies
There are many advanced therapies on which scientists are working upon and these are:
- Mixed therapies
- Flow diversion
- Proton beam treatment
- Hereditary testing
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Challenges associated
- Patient specific treatment
- Long term management
- Limited access to specialized care
