What is Arteriovenous malformation (AVM) surgery?

An arteriovenous malformation, also known as an AVM, is a rare, benign entanglement of blood vessels that cuts off blood flow between the arteries and veins. Blood flows directly to the veins, bypassing capillaries' function of supplying cells with oxygen-rich blood. This can result in bleeding, neurological problems, or even death.

What is the purpose of Arteriovenous malformation (AVM) surgery?

AVM surgery aims at minimizing or eliminating the twisted blood vessels in order to stop any bleeding from occurring.

Now, your blood flows through your capillaries normally again.

What is the type of AVM surgery?

A physician chooses the appropriate course of action after considering the following:

• The size of the AVM
• Its location
• Whether it has burst
• Your age and general health

AVMs can be treated surgically using the following three techniques.

1. Stereotactic radiosurgery: In stereotactic radiosurgery, focused beams of radiation are utilized to seal and thicken the blood arteries within an AVM without damaging the surrounding healthy tissue.

This is the most conservative treatment for an AVM; it does not require a surgical cut. CyberKnife or Gamma Knife are some of the state-of-the-art machinery used in this pain-free surgery.

Stereotactic radiosurgery can be used in combination with endovascular embolization or surgical excision, for those AVMs that are difficult to access.

2. Endoscopy Embolization: The treatable AVMs should be reachable, and a long, thin tube called a catheter could be used. This kind of surgery is noninvasive.

The catheter can be inserted into the artery and then guided by the surgeon to the AVM. With the help of the catheter, the surgeon injects materials into the AVM that block the blood from reaching it.

3. Surgical removal: The only definitive form of surgery is resection, most commonly referred to as surgical removal. It is an extremely risky and invasive type. Doctors typically reserve it for AVMs that have already bled or are at very high risk of bleeding.

Most doctors first shrink the AVM using radiosurgery or endovascular embolization, making it easier to remove without complications.

What is the process of AVM Surgery?

There are three forms of AVM surgery:

• Stereotactic radiosurgery procedure: It may take a couple of hours up to eight hours for the stereotactic radiosurgery. You might have to undergo this treatment twice or thrice throughout a couple of months.

These are the general steps:

1. Doctors apply tiny pins to numb the scalp, round metal frames attached to the scalp, and scalp injections to give the patient relaxing medicine.
2. To ensure that the specific area that needs to be treated is located, a physician may conduct brain imaging tests such as MRIs or CT scans.
3. The table is moving inside a machine which radiates radiation through the holes of the helmet over the scalp applied by the doctor.
4. After the administration of radiation, the metal frame and helmet are removed from your head, and the table is taken out of the machine.
5. To ensure that your recovery is normal, the doctors monitor you for some time.

• Endovascular embolization procedure: You might be given general anesthesia and this procedure done while you are unconscious, or you could be given drugs so that you will relax while you are conscious. Perhaps three to eight hours.

 

In general, the process involves the following:

1. Using X-ray imaging as guidance, a physician places a catheter into an artery in the wrist or groin to supply blood to the AVM.
2. To harden and stop blood flow, the doctor injects embolizing agents into the artery.
3. After that, the surgeon closes the incision and removes the catheter.

Other treatments for AVMs can include sclerotherapy, a similar procedure. While endovascular embolization utilizes injected materials to occlude blood flow, sclerotherapy utilizes an injection of sclerosant; however, both procedures utilize a catheter. This medication destroys the blood vessels within the AVM.

• Resection procedure: In order to keep you unconscious during a resection procedure, general anesthesia is utilized.

In general, the procedures go like this:

1. A neurosurgeon makes an incision in your skull to open up the area, removing part of your skull and then looks upon the blood vessels of the AVM using a microscope.
2. The neurosurgeon carefully dissected and excised the AVM with delicate microscopic instruments so that it does not damage the surrounding structures.
3. Having ensured that all the AVM has been completely removed through imaging technology, the neurosurgeon sutures the incision closed as well as reinstates the bone within your skull.
4. Once you wake up, your medical team will talk to you to determine whether you can understand and respond appropriately.

What are the complications and side effects of Arteriovenous malformation surgery (AVM)?

The following risks and adverse effects are possible with any form of AVM surgery:

• Headache
• Feeling sick
• Tiredness
• Contagion
• Paralysis or convulsion
• Blood vessel injury

Even within 24 hours after AVM surgery, there was a possibility of a brain hemorrhage.

Every type of surgery may also have extra side effects:

• Radiosurgery: In this procedure, a metal plate is attached to the scalp, which can cause bruising, tenderness, or even temporary hair loss, with swelling in the treated area.
• Endovascular embolization: It may show symptoms such as clumsiness in one arm or leg.
• Surgical removal: In surgical removal soreness, numbness, or itchiness around the incision, swelling or bruising around the eyes are some symptoms.

What is the survival rate of AVM surgery?

A meta-analysis in 2023 reported the adverse outcome rate after surgery of AVM to lie between 10% for small AVMs to more than 30% for large AVMs.

The size, your age and location of the AVM may also affect your survival rate.

What is the recovery time of AVM surgery?

After an AVM is surgically removed, most individuals can return to work or their normal routines within four to six weeks. Up to six months may transpire before you fully recover.

In radiosurgery and endovascular embolization cases, you can usually return to your regular activities the day after the procedure.

Why Tender Palm Super-Speciality Hospital for Arteriovenous malformation (AVM) surgery in Lucknow, India?

Tender Palm Super-Speciality Hospital is one of the best hospitals for Arteriovenous malformation surgery in Lucknow, India. We have a highly experienced team of vascular surgeons who use advanced tools and follow international standard infection control measures. Our hospital ensures safer procedures, quicker recovery, and improved long-term outcomes.

To seek an expert consultation for Arteriovenous malformation surgery in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

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