Arteriovenous Malformation (AVM) is a complex neurological condition where there is an abnormal connection
between arteries and veins. This can lead to various symptoms depending on their location or even bleeding in and
around the viscera or cavity effected. The treatment of AVMs often involves a multidisciplinary approach, including
surgery and endovascular therapy.
Surgical intervention for AVMs is known as microsurgical resection. It is typically considered when the AVM is
located in an accessible area and poses significant risks if left untreated. During the procedure, the previously
mapped AVM is removed while preserving surrounding tissue. Advanced techniques like intraoperative monitoring
and neuro monitoring are often employed to maximise safety and efficacy. The goal is to eliminate the risk of
bleeding and reduce associated symptoms.
Endovascular therapy, on the other hand, is a minimally invasive procedure used to treat AVMs, especially those that
are difficult to access surgically. This approach involves navigating to the AVM through the vascular system using a
catheter. Once the catheter reaches the AVM, a variety of techniques can be used to disrupt the abnormal blood
flow. One common method is embolisation, where materials like glue or coils are injected to block the abnormal
vessels, reducing the risk of bleeding.
Both surgical resection and endovascular therapy have their advantages and risks. Surgery offers a more immediate
and definitive solution but comes with higher risks of complications like hemorrhage and neurological deficits.
Endovascular therapy, while less invasive and with a shorter recovery time, may not always completely eliminate the
AVM and might require multiple sessions.
The choice between these treatments depends on various factors, including the size, location, and characteristics of
the AVM, as well as the patient's overall health and preferences. A detailed assessment by a team of surgeons,
interventional radiologists, and other specialists is crucial in devising the most appropriate treatment plan. In some
cases, a combination of both surgical and endovascular approaches may be employed to achieve the best
outcomes.