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Arteriovenous Malformation (AVM) Surgery in Mukundapur

Arteriovenous Malformation (AVM) Surgery

Best Arteriovenous Malformation (AVM) Surgery in Mukundapur

Arteriovenous Malformation (AVM) is a congenital disease, and though its incidence is rare, it can become problematic between 20-40 years of age. In this condition, the arteries and veins in the brain, brainstem, or spinal cord form an abnormal tangle, disrupting the normal flow of blood in the brain. If left untreated, it leads to some serious neurological symptoms such as internal bleeding, strokes, and seizures. It is possible to experience AVM without any adverse effects, but it's always better to remove its risk through surgery. Arteriovenous Malformation (AVM) Surgery is a treatment option for AVM that aims to remove this, reducing the risk of complications and improving patient outcomes. Specialised neuroradiological scans such as MRI and angiography are used to diagnose the AVM location before the surgery precisely. 

The Neurosurgery Department at Manipal Hospitals, Mukundapur, has advanced imaging techniques and experienced neurosurgeons proficient in successfully removing AVMs through Arteriovenous Malformation (AVM) Surgery. We understand the complexity of this procedure and thus provide the best treatment outcomes, tailored to meet your diverse needs. The success of AVM surgery depends on various factors and can carry some risks. With the use of meticulous surgical techniques and comprehensive preoperative evaluation, we aim to optimise outcomes and minimise complications in Arteriovenous Malformation (AVM) Surgery in Mukundapur. Long-term follow-up with imaging studies is essential to ensure the AVM has been successfully treated and to detect any potential recurrence. To provide comprehensive care and long-term outcomes to AVM patients, we follow a collaborative approach comprising neurosurgeons, interventional radiologists, neurologists, and other healthcare providers.
 

FAQ's

There are mainly two types of AVMs 

  • Brain Arteriovenous Malformation: This type of AVM can develop on the surface of your brain or anywhere within your brain tissue. It mostly occurs in the brain, spinal cord, or brainstem.

  • Peripheral Arteriovenous Malformations: This type of AVM can develop in blood vessels of any body part and happens in arms, legs, the face, tissues, or organs of the lungs, liver, or heart.

The symptoms of AVMs usually depend on their location and can get worse with age, during pregnancy, puberty, or after an injury or trauma. However, AVM sometimes does not show any symptoms unless internal bleeding starts, which leads to stroke or brain damage. Its symptoms to note are: 

  • Seizures

  • Brain bleed (haemorrhage)

  • Back pain

  • Headache

  • Muscle weakness

  • Nausea and vomiting

  • Dizziness

  • Mental confusion, dementia, or hallucinations

  • Loss of sensation in any body part

  • Speech, thinking, balance, movement, or vision problems

  • Facial paralysis

  • Drooping eyelids

  • Cold or blue fingers or toes

  • Loss of consciousness

After reviewing the symptoms and performing a physical exam, the doctor may listen for a sound called bruit, which is a rapid blood flow sound. You may be asked to undergo certain diagnostic tests to confirm the diagnosis of Arteriovenous Malformation. The common diagnostic tests used for its imaging include:

  • CT scan

  • Computed tomography angiography (CTA)

  • Cerebral angiography

  • MRI

  • Cerebral magnetic resonance angiography (MRA)

  • Catheter angiography

  • Transcranial doppler ultrasound

Though AVMs sometimes do not show any symptoms, they may be detected during an imaging test used for any other condition, such as vision problems, headaches, or injuries.

Preparing for an AVM surgery involves the following steps:

  • Inform the doctor about all the medications you are taking and ask what medications are allowed on the day of the surgery.

  • A comprehensive assessment of your medical history, neurological status, and imaging studies will be done before the surgery.

  • You will not be allowed to drink or eat anything for at least 8 hours before the surgery.

  • In case of surgical removal of AVM, incision site hair will be shaved, and the scalp will be cleaned.

What types of Arteriovenous Malformation surgeries are there?

There are three types of AVM surgeries, and our neurosurgeon will decide which one is appropriate for your condition based on its location, size, whether the AVM has ruptured age, and overall health. 

  • Stereotactic Radiosurgery

In this form of surgery, focused radiation beams are used to close or thicken the AVM’s blood vessels without destroying the healthy tissues. It is the least invasive surgery for treating AVM that does not require an incision. This painless surgery is conducted using sophisticated equipment, like a cyberknife or gamma knife. Stereotactic Radiosurgery is used in cases where the AVM is difficult to reach and is sometimes used together with Surgical Removal or Endovascular Embolisation surgeries.

  • Endovascular Embolisation

This type of AVM surgery is less invasive and apt for AVMs which can be reached through a catheter. In this surgery, the surgeon inserts the catheter, which is a thin, long tube in an artery, and guides it to the site of the AVM, and certain materials are injected to stop blood from flowing to the AVM.

  • Surgical Removal or Resection

This surgery is used for completely removing the AVM, but it carries a lot of risks and is thus recommended only for cases in which the AVM has ruptured or is at a higher risk of rupturing. The doctor may first use radiosurgery or endovascular embolisation before the surgical removal to shrink the AVM, thereby reducing its associated complications. 
 

The procedure to surgically remove the AVM is performed as follows:

  • You will be given general anaesthesia to ensure you are unconscious and pain-free throughout the procedure.

  • You will be made to lie in a suitable position, such as supine or lateral, depending on the location of the AVM.

  • A Craniotomy (for brain AVMs) or Laminectomy (for spinal AVMs) will be performed to access the abnormal blood vessels.

  • Our surgeon will carefully dissect the surrounding tissues to expose the AVM while avoiding damage to critical structures.

  • By using microsurgical techniques, our neurosurgeon will separate and remove the AVM or seal off its blood vessels to prevent bleeding.

  • The surgical incision will then be stitched using sutures or staples, and dressing will be applied to promote healing.

  • After the surgery, you will be transferred to the intensive care unit (ICU) or neurosurgical ward for close monitoring of your neurological status and vital signs. 

  • You will be discharged within 4-6 days if there are no complications after the surgery.

  • We will provide postoperative care, pain management, and rehabilitation to support your recovery and regain lost function.

  • Regular follow-up appointments and imaging studies will be arranged to assess the outcome of surgery and monitor for any potential complications or AVM recurrence.

After discharge from the hospital, you will need to take proper rest, and you can typically resume activities after 4-6 weeks of AVM surgery if all postoperative instructions are followed properly. But it may take up to 6 months to fully recover.
 

AVM Surgery is a complex surgery and may carry certain risks, such as:

  • Stroke or seizure

  • Infection

  • Fatigue

  • Nausea

  • Headache

  • Artery damage 

  • Swelling or bruising around the eyes

  • Numbness, soreness, or itchiness around the incision

  • Risk of haemorrhage

  • Problems with speech or memory

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