Malformation, arteriovenous (AVM)
Surgery, which is the best-known and longest-standing treatment for AVM. Surgery for an AVM involves identifying the margins of the malformation, ligating (tying off) or clipping the feeder arterial vessels, obliterating the draining veins, and removing or obliterating the nidus (the nest) of the AVM.
Endovascular occlusion, which involves closing off the vessels of the AVM by one of various nonsurgical means. Catheters can deliver agents to block the blood vessels that include permanent balloons, thrombosing (clogging) coils, sclerosing (hardening) drugs, and fast-acting embolization glue (embolization is often used before surgery).
Radiosurgery, which involves focusing multiple radiation beams on the AVM so as to injure and thrombose (clog) the AVM. The effect of radiosurgery takes weeks to months to become fully manifest. A real danger of radiosurgery is damage to neighboring nervous system tissue, normal brain (or spinal cord) tissue around the AVM. Therefore, radiosurgery is usually reserved for AVMs that are relatively small (less than 3 cm in diameter), situated so deep within important brain tissue that surgery is hazardous, or have so many feeder arteries that embolization is not feasible.
Most people (perhaps 80% or more) with AVMs never experience problems due to them. However, AVMs that hemorrhage can lead to serious neurological problems, and sometimes death.
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