Arteriovenous Malformation or AVM

Arteriovenous malformations, also known as AVMs, occur when arteries and veins become tangled, creating abnormally high pressure in the blood vessels. AVMs usually happen in the brain and can lead to life-threatening complications.

At Henry Ford Health, we are experienced in treating this complex condition.

What is an AVM?

To understand AVMs, it’s helpful to know more about your blood vessels:

• Arteries deliver the steady supply of oxygen-rich blood the brain needs to function.
• Veins take blood back to the heart for re-oxygenation.

With an arteriovenous malformation, abnormal connections between arteries and veins divert blood away from the brain, lowering oxygen levels. Blood vessels in an AVM are weaker than usual and widen under the constant force of blood flow. Weakened vessels can burst (AVM rupture) leading to life-threatening complications, like a hemorrhagic stroke.

Arteriovenous malformation care at Henry Ford: Why choose us?

We have been at the forefront of AVM care since the mid-1970s. Our contributions to the field include pioneering efforts to classify different types of AVMs and how to treat them. We share our knowledge with experts all over the world through publications and speaking engagements.

Highlights of our program include:

• Team approach: You benefit from the coordinated recommendations of multiple Henry Ford specialists. Our team includes neurosurgeons, neuroradiologists, radiation oncologists and endovascular specialists. We work together to accurately diagnose the AVM and determine the treatments that are best for your needs. Meet our team.
• Leading therapies: When a procedure is necessary, we often use minimally invasive (endovascular) techniques. These procedures use long thin tubes with instruments at the tip to access the AVM. Experts then cut off the AVM’s blood supply, making it safer to perform surgery or limiting the risk of a rupture if you can’t have surgery.
• Comprehensive care: We offer all the AVM services you need in one program. For AVM ruptures, your recovery starts with specialized care in our neurocritical ICU. Our cerebrovascular disease clinic provides lifelong monitoring for signs of recurrence.

Types of arteriovenous malformation we treat

Types of AVM we treat include:

• Cavernous malformation: This type of malformation does not divert much blood away from the brain. But it often causes bleeding, headaches and seizures.
• Dural fistula: These AVMs affect the brain’s protective lining (dura mater).
• Giant AVMs: Malformations that are larger than usual and measure up to 6 centimeters.
• Hemangioma: Blood vessel malformations that occur on the brain’s surface or your face.
• Spinal arteriovenous malformations: AVMs that occur along the spinal canal or the spine’s protective covering.
• Venous malformation: Abnormalities that only affect the veins.

AVM symptoms

Arteriovenous malformations typically do not cause symptoms until after they burst. Symptoms are often severe and come on suddenly. They include:

• Confusion
• Difficulty speaking
• Dizziness
• Muscle weakness
• Seizures
• Vision problems, like blurry or double vision

If you are experiencing these symptoms or think you are having a hemorrhagic stroke, dial 911. Members of Henry Ford’s cerebrovascular team are on standby 24 hours a day to deliver lifesaving care.

Diagnosing arteriovenous malformations

At Henry Ford you have access to any type of imaging study you may need. We often use noninvasive imaging tests that evaluate blood vessels from outside your body. These include:

• Magnetic resonance imaging (MRI) uses a powerful magnet and radio waves to detect AVMs.
• Computed tomography (CT) scans involve taking X-rays from different angles. A computer assembles them to create 3D images of AVMs. Read more about CT scans.
• Ultrasound captures blood vessel images using a handheld device and soundwaves. This test helps us determine the impact of an AVM on blood flow.

For a more detailed evaluation, we use angiography. This procedure assesses blood vessels from within your body with the help of long thin tubes (catheters).

AVM treatment

Your personalized treatment plan may include:

• Surgery: We may recommend surgery to repair AVMs that have bled and are in areas we can safely access. We use sophisticated imaging methods during surgery, including angiography and MRI, to deliver precise care.
• Stereotactic radiosurgery: For smaller AVMs we cannot safely reach with surgery, you may benefit from stereotactic radiosurgery. This option uses high-energy radiation beams to damage vessels feeding the AVM.
• Endovascular embolization: After accessing the AVM, we block the dangerous blood vessels in the AVM by injecting a glue-like substance. We may also use microcoils, tiny spring-like devices that fill the AVM preventing blood from flowing through it.
• Medications: You may benefit from drugs that manage certain symptoms, like headaches or seizures. But medications cannot prevent AVM ruptures.