Brain/Spine AVM Embolization

Arteriovenous malformation embolization is a procedure performed to alleviate symptoms caused by arteriovenous malformations (AVMs) and prevent blood vessels from rupturing. If blood vessels in an AVM rupture, hemorrhaging will occur, which may cause stroke or damage to the spinal tissue.

AVM embolization is a minimally-invasive technique for blocking the abnormal vessels in the AVM, either before of after a rupture occurs. An interventional neuroradiologist threads a catheter, through a small incision in the groin to the site of the AVM. Through the catheter, the physician injects various materials into the abnormal blood vessels to completely close them. The material used may be tiny particles (microspheres), tiny platinum coils, or a liquid glue.

AVM embolization is commonly used in combination with surgical removal of the AVM or radiosurgery (radiation), or may be the only treatment required. Embolization can decrease the size of the AVM and decrease blood flow within the AVM, making surgery or radiosurgery safer and more effective.

In certain circumstances, embolization alone may be sufficient to totally block blood flow to the affected area, eliminating the need for additional treatments. AVM embolization typically requires more than one treatment to achieve complete occlusion.

Your doctor will determine the best treatment(s) to use based on your medical history, symptoms, and the size and location of the AVM.

This page contains the following information about brain/spine AVM embolization:

Reasons for Having Brain/Spine AVM Embolization

AVM embolization is done to treat arteriovenous malformations in the brain and spine. It can be done as a preventive measure in people with an un-ruptured AVM, or as a treatment for someone who’s had hemorrhaging (and potentially stroke) from an AVM. It may be used to treat AVMs when surgery is too risky.

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Risks Involved in Brain/Spine AVM Embolization

There are some risks associated with this procedure. AVM embolization of an un-ruptured AVM carries less risk than embolization of a ruptured AVM.

Since a catheter is placed within the blood vessels, there is a risk of damage to a blood vessel, bruising or bleeding at the puncture site, or infection.

You could have an allergic reaction to the contrast material used during the procedure, although rare.

There is a possibility that the material used to block the abnormal vessels won’t adequately stop blood flow. In some cases, repeating this procedure will achieve complete obstruction.

You could experience stroke-like symptoms after the procedure, such as weakness in a limb, numbness, tingling, speech disturbances and visual problems.

Serious complications such as permanent stroke, paralysis, or death are rare.

Conditions to Let Our Doctor Know About

In advance of your exam, let your INVISION radiologist or technologist know if any of the following circumstances apply to you.

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Insurance Coverage for Brain/Spine AVM Embolization

AVM embolization is covered by many insurance carriers. If this procedure is done as a preventive measure, check with your insurance carrier to be sure.

Procedure Locations

AVM embolization is performed by INVISION radiologists at the following INVISION partner hospitals in the Denver, Colorado area:

Consultations for AVM embolizations are done at the INVISION Vascular and Interventional Clinic.

Please note:

INVISION is partially owned by Radiology Imaging Associates (RIA); consequently, your radiologist’s lab coat and your bill, if you receive one, may say RIA rather than INVISION.

Scheduling a Brain/Spine AVM Embolization

To schedule a consultation for a brain/spine AVM embolization, call 720-493-3406.

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Preparing for a Brain/Spine AVM Embolization

Following are the preparation guidelines for AVM embolization. Please contact us at 720-493-3406 if you have any questions.

What to Expect During Your Procedure

If you appear to be a candidate for preventive AVM embolization, you will undergo various exams including a blood test and imaging exams, such as a CT scan, CT angiography, MRI, or MR angiography. These exams will help the radiologist confirm your eligibility for AVM embolization and plan treatment.

When you come in for the procedure, you will be asked to change into a gown. After answering any questions you have, a technologist will start an intravenous (IV) line in your arm. He or she will set up various devices so your heart rate and blood pressure can be monitored throughout the procedure. You may be given conscious sedation for the procedure, but it is more likely you will be given general anesthesia and will sleep during the procedure.

A fluoroscope is used during AVM embolization to allow the radiologist to see the movement of the catheter within the body. The fluoroscope will be moved into position over the abdomen.

After injecting local anesthetic and making a small incision at the groin, the radiologist will thread a catheter into the femoral artery. While watching the fluoroscope images on a computer screen, the radiologist will maneuver the catheter through the arteries and position it in an artery that feeds the nidus of the AVM. Through the catheter, the radiologist will place the selected blocking material (microspheres, coils, or liquid glue) into the abnormal blood vessels. The physician will fill all the abnormal vessels in the AVM.

After the affected blood vessels are completely blocked, the catheter will be withdrawn and the incision cleaned and taped.

The procedure may take several hours to complete, depending on the complexity of the situation. You will then spend several hours in the recovery area. Patients with un-ruptured AVMs often go home the next day, unless they are also scheduled to have the AVM surgically removed. Patients who’ve had a stroke may spend up to ten days in the hospital.

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Recovering from Your Procedure

After the procedure, patients may experience mild nausea and low-grade fever. Patients may also have headaches that last for seven days to six months after the procedure.

Patients with an un-ruptured AVM typically recover in 24 hours and can resume their normal activities. Recovery time varies for patients who’ve had a stroke or spinal tissue damage.

AVM embolization is intended to prevent future injury to the brain or spine. It is not a cure for damage that has already occurred from the AVM. Some problems, such as seizures or nerve damage, will likely persist, but they may improve.

Follow-Up for This Procedure

It’s very important that you go to all follow-up appointments. If AVM embolization was your only treatment, you will have an angiogram several months after the procedure to ensure the AVM embolization was successful and the abnormal blood vessels have remained blocked.

Watch a Video of This Procedure

The following video, courtesy of Cordis Neurovascular, show an animation of an arteriovenous malformation embolization with liquid glue. This video requires Microsoft Media Player.

  File Size Estimated Download
Time (56k modem)		  
Cordis Liquid Embolic System*
3 MB
8 min.

*Copyright Cordis Neurovascular

Additional Information

The information on this page was taken in part from some of the following web sites. Visit these sites for additional information on brain/spine AVM embolization.

Sources

Additional Sites

A fluoroscope allows the radiologist to see the catheter within the blood vessels and carefully guide it to an artery that feeds the nidus of the AVM. A type of blocking material (microspheres, coils, or liquid glue) is used to fill the abnormal blood vessels in the AVM.