Oct. 18, 2001 A unique treatment at The Ohio State University Medical Center is using surgical glue and coils to correct abnormally connecting blood vessels that are linked to seizures, headaches and sometimes death.
Tangled blood vessels called arteriovenous malformations, or AVMs, are complex lesions in the brain, which cause blood to bypass the brain, said Dr. Gregory Christoforidis, an interventional neuroradiologist at OSU Medical Center. Because there is considerable force on the vessel walls, the AVM can develop or bulge into an aneurysm and then hemorrhage, possibly leading to severe brain damage or even death. With the use of a newly developed surgical glue, doctors can locate and remove AVMs before they erupt, he said.
"The use of glue at the AVM site prior to corrective surgery is more effective than traditional surgery alone," said Christoforidis, who is one of the few doctors in the country trained to perform the procedure. The injection of glue inside the blood vessels is effective in shutting off blood circulation to the AVM; while coils are used to stop blood flow to the aneurysm.
"If there is no blood flowing into the AVM or the aneurysm, neither can bleed during surgery," he said. "The neurosurgeon can remove the AVM with significantly less risk of causing a brain hemorrhage." Removing the AVM results in improved blood flow to the brain said Christoforidis.
During the procedure, a catheter is maneuvered through an artery in the leg, then up through the torso and neck into the brain where the AVM and aneurysm are located. The physician, who is monitoring the placement, guides the catheter into place by x-ray. When the catheter is in position, the glue and coils are deployed. Once the blood flow has stopped, some patients then have the AVM site removed in surgery so there will be no recurrence of an AVM at that location. The aneurysm does not need to be removed said Christoforidis.
"We have had considerable success with both the glue and coil techniques followed by surgical removal of the AVM on the same day," said Dr. John McGregor, a neurosurgeon at OSU Medical Center. "Because the blood flow is stopped before surgery, there is less bleeding and a shorter time in the operating room for the patient -- benefits that reduce possible risks of the surgery."
Christoforidis said doctors do not know exactly how or why people are born with or acquire AVMs and aneurysms, and usually there is no hereditary link. AVMs occur less often than strokes but both have similar symptoms. AVMs can cause numbness or paralysis in one side of the body; difficulty speaking and understanding speech; loss of balance and coordination; seizures; blurred vision; and severe and sudden headache.
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