What is AVM Surgery?
AVM (Arteriovenous Malformation) surgery is a procedure to treat tangled blood vessels in the brain that cause abnormal connections between arteries and veins. These malformations can disrupt blood flow and lead to serious issues like bleeding, stroke, or seizures. Surgery aims to remove, shrink, or block the AVM to restore normal circulation and prevent complications.
Types of AVM Surgery
Arteriovenous malformation (AVM) surgery is done to remove or close off abnormal blood vessel connections between arteries and veins to prevent bleeding or other complications. The choice of procedure depends on the AVM's size, location, and the patient's overall health.
Microsurgical Resection
- The most common treatment for accessible AVMs.
- The surgeon makes an opening in the skull (craniotomy) and uses a microscope to carefully remove the AVM.
- Offers a high chance of complete removal when the AVM is in a safe location.
Endovascular Embolization
- A minimally invasive method where a thin tube (catheter) is inserted into an artery and guided to the AVM.
- A special glue-like material or tiny coils are injected to block abnormal blood flow.
- Often done before surgery or radiosurgery to shrink the AVM and reduce bleeding risk.
Stereotactic Radiosurgery (SRS)
- A non-invasive treatment that uses focused radiation beams to damage AVM blood vessels, causing them to close over time.
- Works best for small, deep AVMs that are hard to reach surgically.
- The closure process can take months to years.
4 to 6 Hours
Surgery Duration
General Anesthesia
Anesthesia Used
3-6 Months
Full Recovery Timeline
When is AVM Surgery Recommended?
Arteriovenous malformation (AVM) surgery is indicated for patients who have been diagnosed with an arteriovenous malformation and are experiencing symptoms or are at risk of potential complications related to the abnormal vascular condition.
The main indications for AVM surgery include:
- Symptomatic AVM: Surgery is recommended for patients with symptomatic AVMs, where the abnormal blood flow leads to neurological symptoms, such as seizures, headaches, weakness, numbness, or other neurological deficits.
- Recurrent Bleeding: If the AVM has previously bled and poses a high risk of recurrent bleeding, surgery may be indicated to prevent life-threatening hemorrhages.
- Progressive Neurological Deficits: AVMs that cause progressive neurological deficits or impair the patient's quality of life may require surgical intervention.
- Inoperable AVMs: In some cases, embolization or radiosurgery (gamma knife) may not be feasible or effective, making open surgical resection the preferred treatment option.
- Presence of High-Flow Shunts: AVMs with high-flow shunts and increased risk of complications may require surgical correction.
Symptoms of Arteriovenous Malformations
Here are the common symptoms of arteriovenous malformations (AVMs) in simple terms:
- Headaches that can range from mild to very strong
- Seizures (sudden, uncontrolled body movements)
- Weakness or numbness in the face, arms, or legs
- Blurred vision, double vision, or vision loss
- Trouble speaking or understanding words
- Difficulty walking or keeping balance
- Problems with memory or focus
- Sudden severe headache, nausea, vomiting, or fainting (may mean bleeding in the brain)
Preparing for AVM (Arteriovenous Malformation) Surgery
Preparing for AVM surgery involves a few essential steps to ensure the procedure goes smoothly:
- Medical Evaluation: Full assessment by the healthcare team, including imaging studies to locate the AVM.
- Pre-surgery Instructions: Fasting, stopping certain medications, or adjusting dosages as directed.
- Anesthesia Consultation: Meet with the anesthesiologist to discuss anesthesia options.
- Blood Tests: Routine blood work to ensure you're in optimal condition for surgery.
- Arrange for Post-Op Care: Ensure a caregiver or support person is available after surgery for assistance.
- Mental Preparation: Address any questions or concerns with your surgeon to feel confident about the procedure.
AVM Surgery Procedure Steps
Arteriovenous Malformation (AVM) surgery procedures aim to treat arteriovenous malformations using different techniques based on the size, location, and complexity of the AVM.
Below are the steps for the three common types of AVM surgery procedures:
Microsurgical Resection
- Scalp Incision and Skull Opening: The neurosurgeon makes an incision in your scalp and removes a small section of the skull.
- Examination of Blood Vessels: Using a microscope, the neurosurgeon examines the AVM and surrounding tissues.
- AVM Removal: The surgeon carefully isolates and removes the AVM while protecting nearby structures.
- Closure: The bone is reattached, and the scalp is stitched to close the incision.
Endovascular Embolization
- Catheter Insertion: A catheter is inserted through a blood vessel in the groin and guided to the AVM.
- Delivery of Embolic Agent: A special substance, such as glue or coils, is injected to block the blood flow to the AVM.
- Procedure Completion: The catheter is removed, and the access site is bandaged. This procedure is often combined with other treatments.
Stereotactic Radiosurgery
- Positioning and Imaging: The patient is positioned, and imaging scans are used to locate the AVM precisely.
- Delivery of Radiation Beams: High-dose radiation beams are targeted at the AVM to shrink it gradually over time.
- Post-Treatment Monitoring: Regular imaging is performed to track the AVM's response to treatment.
Each AVM surgery procedure is tailored to the patient's specific needs and may be used alone or in combination to achieve the best results.
Who Will Perform The Arteriovenous Malformation Surgery?
AVM surgery requires a specialized team of healthcare professionals, including:
Recovery After AVM Surgery
AVM surgery recovery time varies depending on the complexity of the procedure and the patient's overall health. Following your surgeon's instructions is essential for safe healing and to prevent complications.
- Hospital Stay: Usually 1-2 days, but may be longer depending on your condition.
- Pain Control: Mild to moderate pain is normal; medications will help manage it.
- Watch for Complications: Report any fever, bleeding, swelling, or new weakness immediately.
- Activity Restrictions: Avoid heavy lifting or strenuous work for a few weeks; follow your doctor's advice before resuming normal activities.
- Follow-up Visits: Regular appointments are needed to check healing and ensure the AVM is fully treated.
- Physical Therapy: If you have weakness or difficulty moving, therapy may help restore strength and mobility.
Lifestyle Changes After Surgery
Following Arteriovenous Malformation surgery, certain lifestyle adjustments may help improve recovery and overall health. These changes aim to support healing, prevent complications, and enhance well-being:
- Avoid strenuous activities until cleared by your surgeon.
- Monitor blood pressure regularly.
- Eat a nutrient-rich, balanced diet that includes fresh fruits, vegetables, whole grains, fish, and nuts.
- Avoid smoking and excess alcohol.
- Attend all follow-up appointments.
- Practice stress management.
Benefits of AVM Surgery
AVM surgery offers several important advantages, helping to protect brain health, improve daily functioning, and reduce the risk of serious complications.
- Prevents life-threatening bleeding
- Reduces stroke risk
- Improves neurological function
- Relieves symptoms like seizures or headaches
- Enhances quality of life
Risks and Complications of AVM Surgery
While AVM surgery is generally safe, there are potential risks involved due to the complexity of the procedure. It's important to discuss these risks with your surgeon before the surgery. Common risks include:
Cost of AVM Surgery in India
The cost of AVM (Arteriovenous Malformation) surgery in India varies depending on the type of procedure (microsurgery, embolization, or radiosurgery), hospital location, and the patient's overall condition. On average, the cost can range from Rs. 2,50,000 to Rs. 7,00,000, including surgery, hospital stay, medicines, and follow-up care. Advanced technology, surgeon expertise, and post-surgical rehabilitation may also influence the total expense.
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