Materiały źródłowe

• #1 Spinal AVM: What It Is, Symptoms, Treatment & Prognosis

  https://my.clevelandclinic.org/health/diseases/spinal-arteriovenous-malformation-avm

  A spinal arteriovenous malformation (AVM) is a tangle of blood vessels near your spinal cord. […] Surgery can remove and cure a spinal AVM. […] Treatment options for spinal AVM include: […] Surgery: A surgeon will remove the spinal AVM and make sure blood vessels flow correctly. […] Most spinal AVM cases require surgery to prevent complications. […] Your outlook is best when a healthcare provider diagnoses and treats this condition before complications begin. […] Surgery can correct a spinal AVM. […] Spinal AVM surgery is usually successful. […] Many factors contribute to the surgery outcome, like your general health and the size and location of the AVM. […] A spinal arteriovenous malformation (AVM) can cause life-threatening complications, so an early diagnosis and treatment lead to the best outcome. Surgery can cure the blood vessel malformation.

• #2 Spinal arteriovenous malformation (AVM) | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/spinal-arteriovenous-malformation-avm?content_id=CON-20251921

  A spinal arteriovenous malformation (AVM) is a tangle of blood vessels that forms on, in or near the spinal cord. […] Without treatment, this rare condition can cause lasting damage to the spinal cord. […] You might not know you have a spinal AVM unless you have symptoms. The condition can be treated with surgery to stop or possibly reverse some of the spinal damage. […] Treatment for a spinal arteriovenous malformation (AVM) may involve a combination of approaches. Treatment can lessen symptoms and lower the risk of possible complications. […] The goal of spinal AVM treatment is to lower the risk of the AVM bleeding. Treatment also can stop or prevent disability and other symptoms from getting worse. […] Surgery is often needed to remove a spinal AVM from the surrounding tissue. […] Endovascular embolization can lower the risk of bleeding and other complications of spinal AVMs. […] Your healthcare team discusses with you the benefits and risks of surgery to remove the spinal AVM.

• #3 Mayo Clinic Health Library – Spinal arteriovenous malformation (AVM) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20251921

  Treatment for a spinal arteriovenous malformation (AVM) may involve a combination of approaches. Treatment can lessen symptoms and lower the risk of possible complications. The choice of treatment depends on the size, location and blood flow of the spinal AVM. The results of your neurological exam and your overall health also are taken into account. […] The goal of spinal AVM treatment is to lower the risk of the AVM bleeding. Treatment also can stop or prevent disability and other symptoms from getting worse. […] Pain-relieving medicines may be used to reduce symptoms such as back pain and stiffness. But most spinal AVMs may eventually need surgery. […] Surgery is often needed to remove a spinal AVM from the surrounding tissue. There are three ways to remove spinal AVMs: […] Conventional surgery. A surgeon makes a cut in the skin to remove the AVM. The surgeon takes care not to damage the spinal cord and surrounding areas. Surgery usually is done when the AVM is fairly small and in an area of the spinal cord that is easy to reach.

• #3 Mayo Clinic Health Library – Spinal arteriovenous malformation (AVM) | Swiss Medical Network

  https://www.swissmedical.net/en/healtcare-library/con-20251921

  Endovascular embolization. Endovascular embolization can lower the risk of bleeding and other complications of spinal AVMs. […] A catheter is inserted into an artery in the leg. The catheter is then threaded to an artery in the spinal cord that feeds the AVM. Small particles of a gluelike substance are injected. This blocks the artery and reduces blood flow into the AVM. This procedure doesn’t permanently destroy the AVM. […] You may need endovascular embolization before other types of surgery. This can lower the risk of bleeding during surgery or shrink the AVM so that surgery is more successful. […] Radiosurgery. This procedure uses radiation focused directly on the AVM to destroy the blood vessels of the malformation. Over time, those blood vessels break down and close. Radiosurgery is most often used to treat small AVMs that haven’t burst. […] Your healthcare team discusses with you the benefits and risks of surgery to remove the spinal AVM. Because the AVM is so close to the spinal cord, spinal AVM surgery is complex. See an experienced neurosurgeon for this type of surgery.

• #4 Spinal arteriovenous malformation (AVM) – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/spinal-arteriovenous-malformation-avm/

  Spinal AVM can go undiagnosed unless you begin experiencing signs and symptoms. The condition can be treated with surgery to halt or possibly reverse some of the spinal damage. […] Treatment for spinal AVM may involve a combination of approaches to lessen symptoms as well as reduce the risk of potential complications. The choice of treatment will depend on the size, location and blood flow of your spinal AVM, your neurological exam, and your overall health. […] The goal of spinal AVM treatment is to reduce the risk of hemorrhage and stop or prevent the progression of disability and other symptoms. […] Pain-relieving medications may be used to reduce symptoms such as back pain and stiffness, but most spinal AVMs will eventually require surgery. […] Surgery is usually needed to remove a spinal AVM from the surrounding tissue.

• #5 Spinal Vascular Malformations and Treatment | SpringerLink

  https://link.springer.com/10.1007/978-1-4614-9212-2_45-1?fromPaywallRec=true

  Spinal vascular malformations are rare, but a diverse group of neurovascular pathologies including arteriovenous malformations (AVMs), cavernous malformations, and dural arteriovenous fistulas (dAVFs) that occur due to developmental derangement of the vascular system. […] Once diagnosed, most spinal vascular malformations need treatment, as the natural history suggests progressive stepwise neurological deterioration. Early diagnosis and timely management in symptomatic patients can result in improvement or stabilization of clinical condition. Treatment should be performed in specialized centers. […] Except spinal cord cavernomas and spinal vascular tumors, all other vascular disorders are initially managed by endovascular embolization, as it is the least invasive but technically challenging and demanding procedure. For cases where embolization is technically not possible or when they fail embolization treatment, surgical treatment is an available option. In select cases a combined therapy might be sensible. Early diagnosis and prompt treatment are essential to alter the natural course and result in clinical improvement.

• #6 Surgical and Endovascular Treatment for Spinal Arteriovenous Malformations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4987445/

  Spinal arteriovenous malformation (AVM) is a broad term that constitutes diverse vascular pathologies. […] To discuss indications and results of surgical and endovascular interventions for spinal AVM, this article refers to the following classification proposed by Anson and Spetzler in 1992: type I, dural arteriovenous fistula (AVF); type II, glomus intramedullary AVM; type III, juvenile malformations; and type IV, perimedullary AVF. […] In general, complete obliteration of the fistula is a key for better outcome in type I dural and type IV perimedullary AVFs. […] On the other hand, in type II glomus and type III juvenile malformations, functional preservation, instead of pursuing angiographical cure, is the main goal of the treatment. […] Proper management of spinal AVM should start with neurological examination and understanding of angioarchitectures, which provide critical information that guides the indication and modality of intervention.

• #7 Surgical and Endovascular Treatment for Spinal Arteriovenous Malformations

  https://www.jstage.jst.go.jp/article/nmc/56/8/56_ra.2015-0327/_article

  Spinal arteriovenous malformation (AVM) is a broad term that constitutes diverse vascular pathologies. […] To discuss indications and results of surgical and endovascular interventions for spinal AVM, this article refers to the following classification proposed by Anson and Spetzler in 1992: type I, dural arteriovenous fistula (AVF); type II, glomus intramedullary AVM; type III, juvenile malformations; and type IV, perimedullary AVF. […] In general, complete obliteration of the fistula is a key for better outcome in type I dural and type IV perimedullary AVFs. […] On the other hand, in type II glomus and type III juvenile malformations, functional preservation, instead of pursuing angiographical cure, is the main goal of the treatment. […] In such cases, reduction of the shunt flow can alleviate clinical symptoms.

• #8 Spinal AVM – Nashville Neurosurgery Associates

  https://www.nashvilleneurosurgery.com/conditions/spinal-avm/

  Endovascular therapy involves placing a catheter into the AVM from the leg (the femoral artery) and injecting glue or beads into the AVM to stop its blood flow. […] The main goal of AVM treatment is to prevent bleeding in the spinal cord, which can cause permanent spine damage. However, some patients may not need treatment for AVMs and may instead be monitored closely for any signs of bleeding. […] At Nashville Neurosurgery Associates, we are proud to be one of the region’s leading neurosurgical centers. Our endovascular team are experts in the care and treatment of spinal arteriovenous malformations.

• #8 Spinal AVM – Nashville Neurosurgery Associates

  https://www.nashvilleneurosurgery.com/conditions/spinal-avm/

  An arteriovenous malformation—also known as an AVM—is an abnormal tangle of blood vessels. When an AVM is present in the spinal cord, it can cause disruptions in the spinal blood supply, as it allows blood to flow directly from arteries to veins, instead of passing through the blood vessels. This disruption can cause cells in the spinal cord to deteriorate or die. Though rare, spinal AVMs can cause bleeding in the spinal cord which can cause permanent spine damage if left untreated. The cause of AVMs is unknown. […] Treatment of spinal AVMs is either by surgery or endovascular therapy. However, each spinal AVM is unique and requires an individualized treatment strategy. […] Surgery involves performing a laminectomy—or removal of bone over the spinal cord—in the area of the AVM and removing it.

• #9 Spinal arteriovenous malformation (AVM) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-arteriovenous-malformation/diagnosis-treatment/drc-20355618

  Mayo Clinic neurosurgeons use the latest tools and techniques to treat spinal AVM. […] Treatment for a spinal arteriovenous malformation (AVM) may involve a combination of approaches. Treatment can lessen symptoms and lower the risk of possible complications. The choice of treatment depends on the size, location and blood flow of the spinal AVM. The results of your neurological exam and your overall health also are taken into account. […] The goal of spinal AVM treatment is to lower the risk of the AVM bleeding. Treatment also can stop or prevent disability and other symptoms from getting worse. […] Pain-relieving medicines may be used to reduce symptoms such as back pain and stiffness. But most spinal AVMs may eventually need surgery. […] In endovascular embolization for AVM, a catheter deposits particles of a gluelike substance in the affected artery to block blood flow.

• #9 Spinal arteriovenous malformation (AVM) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-arteriovenous-malformation/diagnosis-treatment/drc-20355618

  Surgery is often needed to remove a spinal AVM from the surrounding tissue. There are three ways to remove spinal AVMs: […] Conventional surgery. A surgeon makes a cut in the skin to remove the AVM. The surgeon takes care not to damage the spinal cord and surrounding areas. Surgery usually is done when the AVM is fairly small and in an area of the spinal cord that is easy to reach. […] Endovascular embolization can lower the risk of bleeding and other complications of spinal AVMs. […] Radiosurgery. This procedure uses radiation focused directly on the AVM to destroy the blood vessels of the malformation. Over time, those blood vessels break down and close. Radiosurgery is most often used to treat small AVMs that haven’t burst. […] Your healthcare team discusses with you the benefits and risks of surgery to remove the spinal AVM. Because the AVM is so close to the spinal cord, spinal AVM surgery is complex. See an experienced neurosurgeon for this type of surgery.

• #10 Arteriovenous Malformations and Fistulas (AVM/AVF) of the Spinal Cord Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative, Intraoperative, and Postoperative Details

  https://emedicine.medscape.com/article/248456-treatment

  There are no acceptable pharmacologic means to treat spinal vascular malformations. Use of glucocorticoids may improve the patient’s neurologic function for a short period. These steroids decrease vasogenic edema, but they do not treat the underlying pathology of the disorder. Unfortunately, these medications have long-term adverse effects. Prolonged use of steroids is associated with adverse systemic effects such as gastric ulceration, elevated blood glucose levels, and suppression of the immune system. […] Each spinal vascular malformation is a unique lesion; therefore, an individualized treatment algorithm must be tailored to each patient. Surgical treatment options include open surgical ligation or resection of the malformation, endovascular occlusion, spinal radiation, and a combination of these techniques.

• #11 Arteriovenous Malformation (AVM): Causes & Symptoms

  https://my.clevelandclinic.org/health/diseases/16755-arteriovenous-malformation-avm

  An arteriovenous malformation (AVM) can cause bleeding or damage to tissues around it. Treatments can remove an AVM, shrink it or stop blood from flowing through it. […] The goal of arteriovenous malformation treatment is to reduce the chance of bleeding or make it permanently go away. There are several different ways to treat it. These treatment types include open surgery, catheter-based artery blocking, and/or focused radiation to the AVM. […] Treating an arteriovenous malformation as soon as possible is usually the best way to avoid serious complications. […] Surgery to remove the AVM involves making a small cut near the AVM, sealing the surrounding arteries and veins so they don’t bleed, then removing the AVM. […] Embolization can also slow blood flow to reduce rupture if a surgeon doesn’t operate immediately.

• #12 Neurosurgical Consultants: Spine Disorders: Spinal Arteriovenous Malformations

  https://www.neurosurgerydallas.com/2_2_2_11.php

  TREATMENT […] Medical therapy […] There are no effective pharmacological means available to treat Spinal Vascular Malformations. […] It is common to use „Steroids” in an attempt to acutely improve the patient’s neurologic function since steroids can decrease the swelling (edema) that often accompanies an injury to the Spinal Cord. There is no place for the long-term use of steroids since they do nothing to treat the underlying pathology of the disorder and have deleterious side effects such as gastric ulceration, elevated blood glucose levels, and suppression of the immune system. […] Surgical therapy […] Treatment must be custom tailored to each patient since each Spinal Vascular Malformation is a unique lesion. The present surgical treatment options include open microsurgical ligation and/or resection of the malformation. Some can be treated using Minimally Invasive Microendoscopic techniques. […] Endovascular occlusion using various methods of „embolization” is a common and often preferential treatment method for many of these lesions. […] Radiosurgery is also an important method of treatment for some lesions. Spinal radiation is not without risk however the advances in radiosurgery are making it increasingly safer.

• #13 Surgical and Endovascular Treatment for Spinal Arteriovenous Malformations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4987445/

  Finally, close collaboration of the microsurgical and endovascular teams are mandatory for successful treatment. […] Two effective treatment options, namely surgery and endovascular treatment, are available for type I spinal AVM. […] Surgery of DAVF is a simple procedure intending to disconnect a draining vein at the point where it intradurally emerges from the fistula. […] It is a safe and highly effective procedure with a reported success rate of approximately 98%. […] Recent technical advancement, including indocyanine green video angiography and 3D computer graphics, further contributed to making surgical intervention a safe and reliable option in treating spinal DAVF. […] During endovascular treatment, which is another option for spinal DAVF, complete obliteration of the proximal portion of the draining vein is a key for success.

• #14 Spinal Arteriovenous Malformation Diagnosis & Treatment – NYC | Columbia Neurosurgery in New York City

  https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-arteriovenous-malformation

  A spinal arteriovenous malformation (spinal AVM) is an abnormal tangle of blood vessels in the spinal cord. […] Spinal AVMs are often treated with a procedure called endovascular embolization. This technique does not require surgery and involves passing a tiny catheter, or tube, into the vessels feeding into the AVM. Once in place, the catheter releases a glue-like material or tiny particles that can seal off sections, or in some cases all, of the malformation. However, for reasons that have to do with blood flow and vessel anatomy, this procedure may not be effective in every case. […] Radiation therapy, also called stereotactic radiosurgery, is another nonsurgical option that may destroy the abnormal vessels of an AVM. […] In some cases, surgery may be necessary. Using a surgical microscope and extremely fine instruments, neurosurgeons can microsurgically remove the malformation to restore the normal blood flow. […] Spinal AVMs are complex lesions, and should be addressed at major centers with experts who are experienced in their treatment, like those at the Spine Hospital at the Neurological Institute of New York.

• #15 Spinal Arteriovenous Malformation – Dr. Paul C. McCormick

  https://www.paulcmccormick.com/condition/spinal-arteriovenous-malformation/

  Spinal AVMs are often treated with a procedure called endovascular embolization. This technique does not require surgery and involves passing a tiny catheter, or tube, into the vessels feeding into the AVM. Once in place, the catheter releases a glue-like material or tiny particles that can seal off sections, or in some cases all, of the malformation. However, for reasons that have to do with blood flow and vessel anatomy, this procedure may not be effective in every case. […] Radiation therapy, also called stereotactic radiosurgery, is another nonsurgical option that may destroy the abnormal vessels of an AVM. […] In some cases, surgery may be necessary. Using a surgical microscope and extremely fine instruments, neurosurgeons can microsurgically remove the malformation to restore the normal blood flow. […] Spinal AVMs are complex lesions, and should be addressed at major centers with experts who are experienced in their treatment, like those at The Spine Hospital at The Neurological Institute of New York.

• #16 Surgical and Endovascular Treatment for Spinal Arteriovenous Malformations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4987445/

  In spinal DAVF, clinical symptoms worsen without appropriate treatment, and it has been estimated that 50% of untreated patients become severely disabled within 3 years of the onset. […] Considering that the degree of preoperative neurological deficit can be a strong prognostic factor of the outcome, prompt diagnosis and treatment play an important role in achieving good outcomes in symptomatic spinal DAVF cases. […] First-line treatment is embolization because surgical treatment aiming to remove the nidus from the spinal cord carries a significant intraprocedural risk. […] Although a few previous reports indicated that surgery is a feasible option in type II intramedullary AVM, surgery should only be indicated for symptomatic cases when embolization is too hazardous or if endovascular treatment results in an incomplete obliteration.

• #17 Surgical and Endovascular Treatment for Spinal Arteriovenous Malformations

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4987445/

  With recent advances in embolic materials and devices in endovascular treatment, transarterial embolization plays an increasingly important role in the treatment of AVM. […] Complete angiographical obliteration of the nidus is not necessarily the goal of embolization, but rather, the treatment aims to reduce shunting volume and stabilize the symptoms. […] Radiosurgery is another treatment option for type II AVM. […] Optimal treatment strategy for type III juvenile malformations remains to be established. […] Therefore, intervention is aimed at halting the progression of neurological symptoms and minimizing neurological sequelae. […] In type IVb cases, an optimal treatment strategy remains to be established. […] Overall, endovascular and surgical treatment offer comparable results with 74% and 88% obliteration rates, respectively. […] In total, 70% patients improved after interventions. […] Classifying the spinal AVM cases based on angiographical characters is important for selecting proper surgical and endovascular treatments.

• #18 Spinal Cord Arteriovenous Malformations (AVMs) – Neurologic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/neurologic-disorders/spinal-cord-disorders/spinal-cord-arteriovenous-malformations-avms

  Surgery is indicated if spinal cord function is threatened, but expertise in specialized microtechniques is required. […] Stereotactic radiosurgery is helpful if the AVM is small and located in a surgically inaccessible location. […] Angiographic embolization occludes feeder arteries and often precedes surgical removal or stereotactic radiosurgery. […] If spinal cord function is threatened, treat surgically.

• #19 Arteriovenous Malformation (AVM) Treatment & Surgery | Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurosurgery/arteriovenous-malformations-treatment?TRILIBIS_EMULATOR_UA=aqkljlpwmmkitx%2Caqkljlpwmm%2Caqkljlpwmmkitx%2Caqkljlpwmmkitx%2Caqkljlpwmmkitx%2Caqkljlpwmmkitx%3Fcmp%3Dhrgn

  Surgical Treatment (also called Open Microvascular Neurosurgery) involves using a microscope. Specialized techniques are used to remove the AVM from the spinal cord or brain. The advantage is that the AVM is then considered cured. […] Stereotactic Radiosurgery (SRS), or Gamma Knife Treatment, uses highly focused radiation that targets and intentionally damages blood vessels of the AVM. These damaged vessels produce scar tissue, which eventually seals off the brain AVM over time. […] Advanced surgical techniques for AVM repair can bring life-changing results for someone living with an AVM. […] Before your AVM treatment, the BWH neurosurgery team will detail what you can expect both before the day of treatment and following the treatment. […] For those undergoing AVM surgery, embolization or sclerotherapy may be done before surgery to reduce the impact or risk of surgery.

• #19 Arteriovenous Malformation (AVM) Treatment & Surgery | Brigham and Women’s Hospital

  https://www.brighamandwomens.org/neurosurgery/arteriovenous-malformations-treatment?TRILIBIS_EMULATOR_UA=aqkljlpwmmkitx%2Caqkljlpwmm%2Caqkljlpwmmkitx%2Caqkljlpwmmkitx%2Caqkljlpwmmkitx%2Caqkljlpwmmkitx%3Fcmp%3Dhrgn

  During AVM surgery, a patient will be under general anesthesia. […] The surgery may last for several hours as neurosurgeons use specialized techniques to remove the AVM from the brain or spinal cord. […] Possible AVM surgery side effects include: Stroke or seizure, Numbness or slow movement, Problems with speech or memory, Small risk of hemorrhage. […] The recovery from AVM surgery begins immediately following the procedure. […] Patients will need to care for their incision and manage any possible swelling or bruising around the eyes following surgery.

• #20 Arteriovenous malformation (AVM)

  https://mayfieldclinic.com/pe-avm.htm

  Surgery, endovascular therapy, and stereotactic radiosurgery can be used alone or in combination to treat an AVM. Endovascular embolization is often performed before surgery to reduce the AVM size and risk of operative bleeding. Radiosurgery or embolization may be used after surgery to treat any remaining portions of the AVM. Your neurosurgeon will discuss with you all the options and recommend a treatment that is best for your individual case. […] If there have been no previous hemorrhages, the doctor may decide to observe the patient, which may include using anticonvulsants to prevent seizures and medication to lower blood pressure. […] Radiosurgery aims precisely focused beams of radiation at the abnormal vessels. The two main technologies are the Leksell Gamma Knife and linear accelerator systems, such as the BrainLab Novalis. The procedure takes several hours of preparation and one hour to deliver the radiation. The patient goes home the same day. After 6 months to 2 years, the vessels gradually close off and are replaced by scar tissue. The advantage of this treatment is no incision and the procedure is painless. The disadvantages are that it works best with smaller AVMs and may take a long time to show effect (during which time the risk of hemorrhage exists).

• #21 Treatment of Spinal Arteriovenous Malformation and Fistula – PubMed

  https://pubmed.ncbi.nlm.nih.gov/35346451/

  With the rapid advancements in endovascular therapy over previous decades, the treatment of spinal arteriovenous malformations (AVMs) continues to evolve. The decision to use endovascular versus surgical therapy largely depends on the type of lesion and its anatomic location. Recent studies demonstrate that endovascular treatment is effective for extradural arteriovenous fistulas (AVFs), intradural ventral (perimedullary) AVMs, and intramedullary spinal AVMs. […] Treatment of intradural dorsal (dural) AVFs remains largely surgical because of lower recurrence rates, although recent studies demonstrate equivocal outcomes. Extradural-intradural (juvenile) AVMs and conus AVMs remain difficult-to-treat lesions.

• #22 Spinal AVM – UF Health

  https://ufhealth.org/conditions-and-treatments/spinal-avm

  The definitive treatment of spinal AVMs is either surgery or endovascular therapy. Surgery involves performing a laminectomy (removal of bone over the spinal cord) over the area of the AVM and removing the lesion. Endovascular therapy involves placing a catheter into the AVM from the groin (the femoral artery) and injecting glue or beads into the AVM to stop its blood flow. […] Each spinal AVM is unique and require an individualized treatment strategy.

• #23 Spinal arteriovenous malformation (AVM) – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/spinal-arteriovenous-malformation/care-at-mayo-clinic/mac-20355620

  Mayo Clinic’s AVM care team has the experience and knowledge to make accurate diagnoses and recommend the best treatment plan for you. […] At Mayo Clinic, neurologists, neurosurgeons, neuroradiologists and other specialists work together as a team to provide expert, individualized care to every person with spinal AVM. […] Your Mayo Clinic care team takes the time to explain and discuss all your treatment options. The team develops an individualized treatment plan based on the location and size of the AVM, your risk of complications, and your overall health. […] Mayo Clinic neurosurgeons have pioneered surgical techniques for AVM and provide a wide range of treatment options. […] With state-of-the-art research and laboratory facilities, Mayo Clinic experts are constantly seeking new medical knowledge and innovations for people with AVM.

• #24 Neurosurgical Consultants: Spine Disorders: Spinal Arteriovenous Malformations

  https://www.neurosurgerydallas.com/2_2_2_11.php

  Combined Therapy […] It is common for Neurosurgeons to recommend a combination of the techniques described above. The use of endovascular embolization followed by microsurgical resection is frequently an effective combination. […] Type 1 Dural AVFs can be treated with either open or endovascular ligation. Both techniques yield excellent results, with successful occlusion rates reported as higher than 80%. Endovascular technique is generally regarded as being less invasive. If the patient has multiple sites of fistula formation, direct microsurgical ligation is more appropriate since all feeding vessels can be ligated under direct vision. […] Direct microsurgery is also necessary in cases where Endovascular access to the arterial feeding vessel is impossible due to the extreme tortuosity of the vascular supply to the AVM or where the arterial blood supply to healthy regions of the Spinal Cord is difficult to spare when attempting the selective obstruction of the blood supply to the AVM. […] Types 2-4 Intradural AVMs are often best treated with Endovascular therapy; however, microsurgical resection may be appropriate for some lesions. The „Juvenile” variety is almost only treated with endovascular therapy. Radiosurgery is appropriate for some lesions as well.

• #25 Arteriovenous Malformations and Fistulas (AVM/AVF) of the Spinal Cord Treatment & Management: Medical Therapy, Surgical Therapy, Preoperative, Intraoperative, and Postoperative Details

  https://emedicine.medscape.com/article/248456-treatment

  The goal of treatment with either agent is to provide distal occlusion of the nidus. Proximal occlusion results in collateral reconstitution, with little hope of cure. […] Regardless of the material chosen for embolization, all procedures should be performed with the patient under general anesthesia with neurophysiologic monitoring, depending on the location of the lesion. […] Patient outcome is directly related to neurologic function at the time of surgical intervention. […] Diagnosing these lesions early and providing appropriate treatment are important if patients are to achieve optimal neurologic outcomes.

• #26 AVM Surgery Procedure Types, Risks, and Recovery

  https://www.healthline.com/health/avm-surgery

  Three types of surgery can remove or reduce an arteriovenous malformation, a tangle of blood vessels that impede blood flow. […] The usual treatment for most AVMs is surgery to remove them or reduce their size. […] The purpose of AVM surgery is to prevent the possibility of bleeding by removing or reducing the tangled blood vessels. […] The following three types of surgery can treat AVMs. […] Stereotactic radiosurgery uses focused radiation beams to thicken and close the AVMs blood vessels without destroying healthy tissue. […] This less invasive type of surgery can only be performed for AVMs that can be reached with a catheter, which is a long, thin tube. […] Surgical removal, or resection, is the only surgery type that completely removes the AVM. […] To lower the risk of complications, a doctor may first use endovascular embolization or radiosurgery to shrink the AVM, making it safer to remove.

• #27 Spinal Arteriovenous Malformations | Loma Linda University Children’s Health

  https://lluch.org/conditions/spinal-arteriovenous-malformations

  Treatment depends on the location and type of AVMs you have and the symptoms they cause. Many people have some improvement in symptoms after the AVM is fixed. You may need: […] Surgery. A neurosurgeon removes the AVM. […] Endovascular embolization. This is less invasive than surgery. A radiologist uses a catheter (small, thin tube) to inject an embolizing material to close off certain vessels. […] Radiation therapy. Focused energy is used to damage and seal off the abnormal vessels. […] Certain medicines. Your healthcare provider may give you medicines to treat symptoms, such as back pain.

• #28

  https://www.advocatehealth.com/health-services/brain-spine-institute/brain-care-center/conditions-treatments/cerebrovascular-malformations/arteriovenous-malformation

  Microsurgery: Microsurgery entails removing a portion of the skull and using a surgical microscope and specialized tools to remove the AVM. […] Following treatment, especially in cases of a ruptured AVM, rehabilitation may be necessary to aid patients in regaining lost function and recovering from any neurological deficits resulting from the AVM or its treatment. Rehabilitation may include physical therapy, occupational therapy or speech therapy. […] Your healthcare provider will work closely with you to determine the most appropriate treatment approach based on your individual circumstances and preferences.

• #29 Endovascular Treatment of Spinal Arteriovenous Lesions: Beyond the Dural Fistula | American Journal of Neuroradiology

  http://www.ajnr.org/content/32/5/798

  In this article, we present the classification and pathophysiology of spinal arteriovenous lesions and the approach to endovascular treatment. […] Treatment planning for spinal vascular arteriovenous lesions is based on the hemodynamics of the lesion, location in the axial and longitudinal plane, and the angioarchitecture. […] Embolization is the treatment of choice for many arteriovenous anomalies. […] However, surgery continues to play a key role, and a multidisciplinary approach is essential. An important consideration before any intervention is a patient’s preoperative neurologic status. […] As with all inherent disease processes of the spinal cord, postoperative function is highly related to preoperative presentation, and maximum functional results are obtained in patients treated early before advanced deterioration. […] Partial results can still be obtained in patients with severe neurologic impairment.

• #29 Endovascular Treatment of Spinal Arteriovenous Lesions: Beyond the Dural Fistula | American Journal of Neuroradiology

  http://www.ajnr.org/content/32/5/798

  SUMMARY: During the past few decades, there have been significant advances in the understanding of spinal vascular lesions, mainly because of the evolution of imaging technology and selective spinal angiography techniques. […] In this article, we discuss the classification, pathophysiology, and clinical manifestations of spinal vascular lesions other than DAVFs and provide a review of the endovascular approach to treat these lesions. […] Increased knowledge of the angioarchitecture and pathophysiology of SVMs has lead to the development of endovascular embolization for these lesions, first described by Dr Djindjian in France and Drs DiChiro and Doppman in the United States. […] Further evolution in imaging technology and interventional and surgical techniques allows us to manage these lesions more efficiently, in the context of a multidisciplinary approach.

• #30 Spinal Avm – Spinal AVM – AVM Survivors Network

  https://avmsurvivors.org/t/spinal-avm/28017

  After 3 weeks rehab, I was able to walk normal and the balance kept improving. […] I was treated with oral Baclofen tablets to control the spasm. […] The specialist treating me also explained to me that every person is different after a SDAVF issue. […] Vitamin K complex (K1 K2 M4 M7) easily found on Amazon has done more for me than 25 other things I tried for my similar spinal AVM. […] I am using the ITB pump since 3 years and currently delivering 460 micro grams of Baclofen a day into the spinal cord.

• #31 Arteriovenous Malformations and Fistulas (AVM/AVF) of the Spinal Cord: Practice Essentials, Background, History of the Procedure

  https://emedicine.medscape.com/article/248456-overview

  Spinal arteriovenous malformations (AVMs) are a rare form of spinal blood vessel defect in which blood is received from the spinal feeding arteries, resulting in vessel engorgement that leads to clinical signs secondary to mass effect and ischemia. They account for about 10-15% of all spinal vascular shunts. Because of the rarity of spinal AVMs, studies regarding their diagnosis and treatment are limited. In addition, the various classifications that have been proposed historically make it difficult for young neurosurgeons to understand this disease. Because delayed initial diagnosis leads to irreversible damage to the spinal cord, neurosurgeons should always consider spinal AVM as part of the differential diagnosis. To understand the pathologic condition of spinal AVM, it is important to learn its basic classifications. Spinal AVM is classified as intradural, dural, and epidural. Spinal digital subtraction angiography (DSA) is the gold standard for diagnosis of spinal AVM and is an indispensable tool for treatment planning.

• #31 Arteriovenous Malformations and Fistulas (AVM/AVF) of the Spinal Cord: Practice Essentials, Background, History of the Procedure

  https://emedicine.medscape.com/article/248456-overview

  For many patients with spinal AVM, the symptoms are nonspecific. Therefore, we consider it critical to detect signal flow voids in enlarged spinal veins by using magnetic resonance imaging (MRI). An accurate understanding of the vascular structures is indispensable for deciding appropriate treatment strategies. Hence, performing an angiography is essential. Regarding treatment, whether to select surgical or endovascular treatment for AVF depends largely on institutional protocols. […] Treatment approaches for spinal cord malformation are being expanded through the use of interventional neuroradiology. With improvements in spinal angiography and endovascular techniques, these lesions may be embolized either as primary treatment or as a complement to open microsurgical techniques. Two treatment modalities are available: endovascular and surgical therapy. Endovascular treatment has improved over the years and offers the advantages of a less invasive approach; therefore, it is usually chosen as primary therapy. However, treatment should always be based on an accurate diagnosis. Eradication can often be incomplete, and risk for spinal cord ischemia may be increased. Stereotactic radiosurgery can be curative in some cases or can facilitate shrinking of the lesion.

• #32

  https://link.springer.com/article/10.1007/s00234-023-03132-x

  Endovascular treatment of spinal AVMs is limited by low complete cure rates. […] We report two cases of symptomatic spinal AVMs treated by a transvenous approach with retrograde pressure cooker technique. […] A transvenous approach for embolization with liquid embolics may offer advantages in treating certain spinal AVMs. […] Endovascular treatment of spinal AVMs is a non-standardized approach to treating this rare disease. […] These are the first reported cases of transvenous treatments of spinal AVMs with liquid embolics (Onyx/Squid) in pressure cooker technique. […] The transvenous approach to AVMs principally offers three particular advantages: 1. Endovascular treatment of the lesion gets feasible also when there is no suitable arterial access. 2. The risk of arterial ischemia might be lower since no direct arterial embolization takes place. However, a retrograde arterial filling might occur. 3. The treatment of the vein allows a definite cure of the lesion, whereas arterial embolization often results only in partial occlusion of shunts and the primary veins.

• #33 A Rare Case of Cervical Spinal Arteriovenous Malformation: A Case Report

  https://www.mdpi.com/1648-9144/60/6/1011

  A Rare Case of Cervical Spinal Arteriovenous Malformation: A Case Report […] Arteriovenous malformation (AVM) is an abnormal connection of vasculature resulting in capillary bed bypassing and leading to neurological deterioration and high risk of bleeding. Intramedullary AVMs in the cervical spinal cord are rare and require precise diagnostics and treatment. […] Treatment is complex and largely dependent on the angioarchitecture of the AVMs, as well as prior treatment approaches and its success rate of reversing AVMs neurological morbidity. Usually, the treatment of AVMs is conducted via endovascular embolization and/or surgery. Endovascular embolization and surgery success rate of complete obliteration of AVMs vary depending on the type. In intramedullary AVMs, complete obliteration is seen in about 33 to 38% and recanalization of AVMs is a common problem requiring repeated embolization and/or surgery. The complete obliteration rate of spinal AVMs after conventional neurosurgery reaches 78%, but the complication rates compared to endovascular treatment are also significantly higher. […] There have been trials to treat AVMs using stereotactic radiosurgery with promising results, indicating that it might be an alternative management strategy for patients who cannot be treated using an endovascular approach or neurosurgery. […] It is difficult to determine the superior treatment modality, but the current approach is to combine endovascular embolization prior neurosurgery with complete or partial resection for better neurological outcome and obliteration rate.

• #34 Spinal arteriovenous malformation (AVM) – Hancock Health

  https://www.hancockhealth.org/mayo-health-library/spinal-arteriovenous-malformation-avm/

  You might not know you have a spinal AVM unless you have symptoms. The condition can be treated with surgery to stop or possibly reverse some of the spinal damage. […] Treatment for a spinal arteriovenous malformation (AVM) may involve a combination of approaches. Treatment can lessen symptoms and lower the risk of possible complications. The choice of treatment depends on the size, location and blood flow of the spinal AVM. The results of your neurological exam and your overall health also are taken into account. […] The goal of spinal AVM treatment is to lower the risk of the AVM bleeding. Treatment also can stop or prevent disability and other symptoms from getting worse. […] Pain-relieving medicines may be used to reduce symptoms such as back pain and stiffness. But most spinal AVMs may eventually need surgery.

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