An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels connecting arteries and veins, which disrupts normal blood flow and oxygen circulation. Arteries fail to branch into smaller capillaries before they drain into the veins. Capillaries functioning as the main structure of blood exchange through diffusion are absent and hence the surrounding tissues remain devoid of nutrition. Thus, an AVM develops shunts called “Nidus” that disrupt the critical process of oxygen availability to neighboring tissues, and thereby the affected arteries and veins can weaken and rupture. AVMs can occur anywhere in the body.
An AVM occurring anywhere in the arms, legs, heart, lungs, liver or the reproductive or genital system, is a peripheral AVM. In a peripheral AVM, the Nidus reduces the blood supply with its nutrients and oxygen to the surrounding tissues and increases the blood pressure in the draining veins and the larger amount of blood going through the arteries and veins.
Through progress, this process damages the surrounding tissue and compels the heart to work harder to circulate the blood. Luckily, arteriovenous malformation treatment is fairly straightforward.
Signs and symptoms of AVM
Signs and symptoms of AVM vary with size and location. The skin over the area turns reddish with warmth initially and as it progresses, the area under the skin swells. Further severity can cause damage to tissues with pain, bleeding, sores, and ulcers. The speed of progression is highly unpredictable. Conditions of hormonal changes during puberty or pregnancy, surgeries, trauma, and injury are risk factors that can fasten growth.
Excessive bleeding is the most common complication of AVM. Continuous bleeding can cause severe damage, sometimes leading to paralysis of the affected limb. Less commonly, high-output cardiac failure can occur with large arteriovenous malformations. Clotting of blood is another complication due to abnormal blood vessels. Other possible concerns may be cosmetic reasons when the AVM is seen through the skin.
Best Treatment for AVM at Laser Vein Clinic
Clinical assessment of Vascular shunting that can predict Arteriovenous malformation treatments is divided into four stages:
- Asymptomatic lesions
- Pain due to necrosis
- Ulceration and bleeding
- High-output cardiac failure
Doppler ultrasound and CT with contrast or MRI are the primary imaging modalities. They deliver an exact anatomical resolution of the AVM and surrounding soft tissue necessary for analyzing the extent of peripheral AVM. Additionally, diagnostic angiography would be mandatory on almost all AVMs and is required prior to treatment to assess flow rate and visualize the anatomy of the nidus. The architecture of the nidus on angiography has implications for treatment and outcomes.
Wearing a graded elastic compression sleeve or stocking, the pressure created on the enlarged veins can alleviate pain and swelling.
A series of embolization procedures are done over spread out time as corrective AVM treatments. The procedure involves the insertion of a thin plastic tube into an artery. This is then maneuvered to the site of the AVM under imaging guidance. A special type of liquid glue, metallic coils, or other substance is then placed or released to stop blood flow to the AVM. Venaseal is one such endothermic embolization that uses glue to occlude the blood vessel without thrombotic complications. Response to treatment is based on the architecture of the nidus and the subsequent sequence of embolization procedures.