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Forum Name: Surgery Topics

Question: AV Malformation


 Mohit12345 - Tue Aug 03, 2010 4:09 pm

Dear Sir,

I am suffering from AV Malformation in the biceps muscle of my left arm. Thre is no swelling/ redishness at this point but I have severe pain in that area all the time.
I have undergone MRI, Doppler and Scelerotherapy for the same but the pain still persist.
Pls advice can I go for Surgery?
What would be the success rate and complications?

Thanks in Advance
 Faye Lang, RN, MSW - Sat Aug 07, 2010 10:39 pm

Hello Mohit12345,

An AV Malformation (AVM) is an abnormal connection between veins and arteries. It is usually a congenital (present at birth) condition, but is not usually genetic, or inherited. AVMs can appear at any location in the body, but the most common is within the central nervous system, particularly in the brain. Approximately 300,000 Americans have AVMs. Depending on location and size, some are more serious than others, but most are problematic to some degree.

Arteries and veins are parts of the cardiovascular system in the body. Except for the pulmonary artery, which carries unoxygenated blood to the lungs, arteries carry oxygenated blood from the heart to the body's cells, and veins carry unoxygenated blood back to the heart. Arteries subdivide again and again, becoming smaller and smaller, until they form what is known as a capillary bed. Arterial blood enters the capillary bed, where oxygen is delivered from the blood to the cells, and Carbon Dioxide (CO2) and cellular wastes are deposited back into the blood, which then exits the capillary bed into veins, which combine and become larger and larger, until it reaches the heart. An AVM lacks the effects of the capillaries and the surrounding area is deprived of effective delivery of nutrients to the cells and effective removal of CO2 and wastes away from the cells. There is a tangle of blood vessels instead, which is fragile and bleeds easily. In some cases, there are no symptoms until the AVM ruptures and hemorrhages.

Treatment of AVMs can consist of simply addressing symptoms, as with pain or other medications, surgical intervention, or radiation therapy. In small AVMs, sometimes embolization, or cutting off the blood supply to the tangle of blood vessels via a radiographically-guided catheter, is the treatment of choice. Embolization is often unsuccessful in larger AVMs. A radiation procedure, called the Gamma Knife procedure, does not involve scalpels but a beam of radiation. The beam damages the AVM vessels, which forms scar tissue. Blood can no longer flow through the tangled vessels, and the body forms collateral circulatory vessels to the area. In smaller AVMs, some researchers contend that the best approach is to accept the risk of damage resulting from the AVM itself should it rupture. However, bleeding from an AVM can have devastating consequences, particularly in cerebral and renal AVMs. Potential complications depend on the size of the AVM and its location. Complications of surgery can be nerve or tissue damage, or formation of blood clots, though complications are not frequent. Complications of the Gamma Knife radiation approach are uncommon, and would consist of more extensive radiation damage than planned. This approach generally requires a one-night hospital stay. The success rate of surgical intervention is good, and with radiation is high. However, it really does depend on the size and location of the AVM whether surgery or radiation is the better choice; your doctor can help you decide on the best surgical intervention for your AVM.

There is an internet support organization, called AVM Survivors, which can give you personal experiences with AVM. Most of them have had cerebral, renal or spinal AVMs, but their information may be helpful to you. The website is at AVMSurvivors.org.

I hope this information helps you in making your decision. Good luck to you.

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