Brain AVM Embolization

MMA EmbolizationWhat is AVM embolization?

AVM embolization is a procedure that can be performed to eliminate blood supply to an AVM. This is typically done prior to surgical resection of an AVM in order to make the surgery safer. Rarely, embolization may be performed prior to radiation treatment of an AVM, or as a standalone treatment.

How is AVM embolization performed?

A catheter is inserted into a large blood vessel through a small puncture site in your thigh or wrist. The catheter is guided through the blood vessels, under X-ray guidance, into the vessels that supply blood to the AVM. An embolic material (typically, a medical grade “glue”) is injected through the catheter to block the blood vessel, thereby slowing down the blood supply to the AVM. The catheter is then removed, and the puncture site in the thigh or wrist is closed, either by holding pressure on the site for approximately 15 minutes, or by using an absorbable closure device. You will have a small bandage over the puncture site on the skin, which can be removed 24 hours after the procedure.

Are there risks?

There are always risks associated with any type of procedure.  Depending on the location of the AVM and the particular vessels that supply it, the risks of AVM embolization may include, but are not limited to, bleeding, infection, blood vessel injury, stroke, weakness, paralysis, visual disturbance, contrast dye reaction, seizure, coma and death.

What will happen after the procedure?

Following the procedure, you will lay flat in bed with your legs straight for 3 hours. You will then be allowed to slowly sit upright and walk. You will spend one night in the hospital under close monitoring. The nurses and doctors will take your vital signs, perform neurological exams, and check your pulses and puncture site at various times throughout your stay. If there are no concerns, you will likely be discharged home the next morning, or in some cases, you will stay in the hospital for your upcoming surgery, depending on when the surgery is scheduled.  In some instances, you will undergo more than one embolization prior to surgery. When multiple embolizations are necessary, they are typically performed 1-2 weeks apart. Surgery is typically planned several days to several weeks after embolization.

What will happen once I’m home?

You will be tired from the anesthesia medications, and so resting is important. We advise against driving and making any important decisions until 24 hours after the procedure. You can use Tylenol, 650mg every 6 hours, as needed for discomfort.

Remove the dressing 24 hours after the procedure and leave the area open to air. Continue to monitor the site for the next 7 days. You may shower 24 hours after the procedure and gently wash the area with soap and water. Pat dry with a clean towel. Do not rub the area. Avoid strenuous activity, lifting over 10lbs, hot tubs and riding a bike for 7 days.  You may resume a regular diet, home medications and light activity such as walking.

What should I look out for?

Monitor the area for redness, swelling, drainage, pain, bleeding or weakness/numbness in your leg. Bruising is normal. If you notice oozing from the site, experience swelling that is tense or your leg becomes cold or weak, please contact our office immediately, or call 911.

Ayer Neuroscience Institute