What is AV-arterio-venous malformation ?
Dr Mamata S.H.
Kalyan nagar, Bengaluru Feb 18, 2017
Congenital defect where in the blood vessels, veins and the arteries are interconnected locally and progressively tend to increase in size due to continuous blood circulation and distension of the blood vessels.
-May enlarge to a larger size to compress the surrounding structures and cause related pressure affects. Like in a case the trachea was compressed and the swelling also caused compression on the major blood vessels of the neck.
-May entangle the nerves that lie close to them and cause nerve related problem like-loss of sensation supplied by that nerve, pain might set in and so on. In this case the superficial cervical nerve was entangled which had to be sacrificed during the surgery.
-May infiltrate the muscle and also has the capability of eroding the underlying bone, usually is affected by a huge malformation involving the limbs.
-Most of the small malformations regress by the growing age (2 years).
-If left untreated minor trauma can bleed (internally/externally) to death.
-Some extensive cases may not be operable which are treated conservatively, especially those affecting the limbs with compression therapy alone.
-At times the malformation is too extensive and the surgical excision may not be possible because of its extensive involvement of the muscles and the bony infiltration.
-Such malformations may be involved at multiple sites, so it’s mandatory to examine and evaluate the whole body.
Modes of treatment:
-Simple forms, situated in the non vital area treated by sclero-therapy (injection of the agents within the vessels to cause regression and collapse of the swelling.
-Endovascular procedure that is by blocking the main arterial feeder / venous channels and disconnecting it completely from the inflow and the outflow, termed as Embolization. This procedure is carried out under local anaesthesia and is technically simple- by just a needle puncture. This might require multiple sittings to block multiple feeders /recurrent development. This procedure is also carried out pre surgically to minimize the bleeding, prior to surgical excision.