What is an arteriovenous malformation?
In normal circulation, blood passes from arteries through capillaries before reaching veins. In an arteriovenous malformation, arteries connect directly to veins through a tangle of vessels called a nidus, bypassing the capillaries. The high-pressure flow this creates makes the malformation grow, distends the draining veins and can steal blood from surrounding tissue.
AVMs are congenital, though they often become noticeable in adolescence, in pregnancy or after trauma. They are distinct from the slow-flow venous and lymphatic malformations, and separating the two on imaging is essential because treatment differs completely.
Symptoms to watch for
- A warm, pulsatile swelling or lump beneath the skin
- A red or purple birthmark-like patch that grows or thickens over time
- Aching, throbbing or a sensation of pressure in the area
- A buzzing or thrill that can be felt, or a bruit heard with a stethoscope
- Prominent, dilated veins around the lesion
- Skin breakdown, ulceration or episodes of bleeding
- Limb swelling, overgrowth or reduced function in extensive lesions
When to seek urgent care
Heavy or repeated bleeding from a malformation, or sudden painful swelling, needs urgent assessment.
How it is diagnosed
Investigation is chosen to answer a specific question rather than as a blanket screen. For arteriovenous malformations that usually means:
- Clinical examination for warmth, pulsatility and thrill
- Colour Doppler ultrasound to distinguish high-flow from low-flow lesions
- MRI and MR angiography to map extent and involvement of deeper structures
- CT angiography where bone involvement is suspected
- Catheter angiography to define feeding arteries and the nidus before treatment
Treatment options at Siva Sakthi
Which of these applies to you depends on what the assessment shows. The options are discussed with you, including what each involves and what recovery looks like.
- ObservationSmall, stable, asymptomatic malformations may simply be monitored, since intervention carries its own risks.
- EmbolisationFeeding vessels and the nidus are occluded through a catheter using coils, glue or liquid embolic agents — often the primary treatment, and sometimes staged over several sessions.
- SclerotherapySclerosant injected under imaging guidance is used chiefly for low-flow venous and lymphatic malformations.
- Surgical excisionRemoval, usually after embolisation has reduced blood flow, for localised lesions or where bleeding and ulceration persist.
- Combined and staged treatmentExtensive malformations are managed with planned, repeated interventions rather than a single procedure.
- Compression and supportive careGarments, wound care and pain management help control symptoms alongside definitive treatment.
Common questions
Some localised malformations can be eliminated by embolisation with excision. Extensive AVMs are more often controlled than cured, and can recruit new feeding vessels over time, so long-term follow-up is planned from the start.
No. Asymptomatic, stable lesions may be safely observed. Treatment is advised when there is pain, bleeding, ulceration, functional loss or documented growth.
Most occur sporadically. A small number are associated with inherited syndromes, which is why family history and any other lesions are asked about.
Book a consultation in Guntur
Arteriovenous Malformations (AVM) is assessed and treated by Dr. Vijay Kumar Vishnumolakala, MS, MCh, at our Kothapeta clinic. Request an appointment or call +91 00000 00000.