Arteriovenous Malformations (AVMs) are abnormal, tangled networks of arteries and veins in the brain or spinal cord that disrupt normal blood flow and oxygen delivery. AVMs are fragile and prone to rupture, which can lead to life-threatening hemorrhages, seizures, and neurological deficits.
AVM Embolization is a minimally invasive, image-guided procedure that blocks off the abnormal blood vessels within the AVM by injecting special agents into them. This can be used as:
- A standalone treatment in smaller AVMs,
- A pre-surgical or pre-radiosurgery step to reduce the risk of bleeding.
At CARE CHL Hospital, Indore, under the leadership of Dr. Alok K. Udiya, our neurointervention team provides AVM embolization using the latest microcatheters and embolic materials like Onyx, NBCA, or coils, depending on the AVM structure.
Our goal is simple: to prevent rupture, reduce symptoms, and enhance long-term neurological outcomes with the least possible risk.
Key Benefits of the Treatment
AVM embolization plays a vital role in managing AVMs—either as a curative step or part of a multimodal approach with surgery or radiosurgery.
Here’s why embolization is so effective:
- Minimally Invasive: Performed through a tiny puncture in the groin or wrist.
- Targeted Treatment: Precisely blocks abnormal vessels without damaging nearby healthy brain tissue.
- Reduces Bleeding Risk: Especially important in ruptured AVMs or those causing seizures.
- Prepares for Safer Surgery: Embolization reduces the size and blood flow in large AVMs before surgery.
- Enhances Radiosurgery Results: Pre-treatment embolization improves the effectiveness of Gamma Knife or CyberKnife therapy.
- Shorter Recovery Time: Most patients recover within 1–3 days.
- Multiple Sessions Possible: Complex AVMs can be treated in stages to minimize risks.
How This Treatment Works
AVM embolization is conducted in a neuroangiography suite equipped with a biplane DSA machine for high-precision navigation and embolic delivery. Here is how it works:
1.
Initial Imaging and Assessment
The diagnosis is confirmed using:
- Digital Subtraction Angiography (DSA): Gold standard to map AVM anatomy.
- MRI/MRA: For identifying brain tissue at risk.
- CT/CTA: For hemorrhage evaluation.
Detailed planning involves understanding:
- Size and location of the AVM
- Feeding arteries, draining veins, and nidus (core)
- Presence of associated aneurysms
2.
Procedure Planning
Depending on the complexity, embolization may be:
- Curative (complete obliteration)
- Adjunctive (combined with surgery or radiosurgery)
- Emergency (for active bleeding)
Dr. Alok customizes the strategy—selecting Onyx, NBCA glue, coils, or particles based on AVM architecture.
3.
The Procedure
- A catheter is inserted through the femoral or radial artery.
- It is advanced into cerebral arteries supplying the AVM.
- A microcatheter is positioned precisely at the nidus or feeder vessels.
- Embolic material is injected under continuous fluoroscopic control, occluding the AVM.
- In many cases, the procedure is staged over multiple sessions to avoid complications.
4.
Recovery and Monitoring
- Patients are monitored in a neurocritical care setting for 24–48 hours.
- Minor headaches, nausea, or transient neurological symptoms may occur.
- Follow-up DSA or MRI is scheduled after 3 months to assess AVM status.
- If planned, surgery or radiosurgery follows in 4–6 weeks.
Why Choose Dr. Alok K. Udiya for AVM Embolization?
AVM embolization is one of the most technically demanding neurointerventional procedures. It requires skill, precision, and careful judgment.
Here’s why Dr. Alok K. Udiya is trusted by both patients and referring doctors:
- Extensive experience with hundreds of complex AVM embolizations
- Advanced training in microcatheter navigation and Onyx embolization
- Access to state-of-the-art biplane neuro DSA lab
- Works collaboratively with neurosurgery, neurology, and radiosurgery teams
- Proven outcomes in ruptured and unruptured AVMs
- Deep understanding of AVM grading (Spetzler-Martin scale) for personalized planning
CARE CHL Hospital ensures a comprehensive ecosystem for AVM care—from diagnosis to treatment and long-term monitoring.
FAQs – AVM Embolization
Q1. What is an AVM?
An arteriovenous malformation (AVM) is a tangled web of abnormal blood vessels connecting arteries and veins, bypassing the normal capillary system. AVMs can rupture, causing brain hemorrhages or seizures.
Q2. Who needs AVM embolization?
Patients with ruptured AVMs, AVMs causing seizures, or those being prepared for surgical or radiosurgical treatment are candidates for embolization.
Q3. Is embolization a cure for AVMs?
In small, localized AVMs, embolization can be curative. In larger AVMs, it is often one part of a combined treatment plan.
Q4. What materials are used during the procedure?
Special agents like Onyx (liquid embolic), NBCA glue, and coils are used to block abnormal blood vessels.
Q5. Is the procedure painful?
No. It is performed under general anesthesia, and patients typically feel no discomfort during the procedure.
Q6. How long is the hospital stay?
Most patients stay 1–3 days, depending on the AVM’s size, location, and symptoms.
Q7. Are there any risks?
Risks include:
- Bleeding or vessel rupture (rare with experienced operators)
- Temporary neurological symptoms
- Post-embolization syndrome (headache, fatigue, mild fever)
Q8. Can AVMs recur after embolization?
If embolization is incomplete, some AVMs may revascularize. Follow-up imaging helps in early detection and retreatment.
Q9. How does this compare to surgery or Gamma Knife?
Embolization is less invasive and often used in conjunction with these treatments. It reduces AVM size and bleeding risk before surgery or radiosurgery.
Q10. Can children undergo this procedure?
Yes. Pediatric AVMs are treated with special care. Dr. Alok has expertise in managing AVMs across all age groups.