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Procedures

AVM Embolization

What Is an Arteriovenous Malformation (AVM)?

An Arteriovenous Malformation, commonly called an “AVM”, is an abnormal connection between an artery and a vein. There are two main types: brain AVM and dural AVM. A brain AVM involves the blood vessels inside the brain, while a dural AVM involves the blood vessels lining the brain.

A brain AVM may cause seizures or severe headaches, in which case it is usually detected on a CT or MRI scan. A brain AVM may also rupture and cause bleeding in your brain, which is a serious emergency. A dural AVM usually presents with characteristic symptoms such as a swollen red eye or a whooshing sound that matches your heartbeat (tinnitus). A dural AVM is often detected on MRI, though a cerebral angiogram may be necessary to detect small lesions.

What Is the Treatment for an Arteriovenous Malformation (AVM)?

Treatment of an AVM usually includes an embolization procedure. An embolization is a specialized, controlled blocking of an abnormal blood vessel, either an artery or vein, depending on the type of AVM. A variety of blocking agents can be utilized, including coils, particles (tiny shavings of a plastic type material), or “superglue”. The type of embolization and blocking agent depends on the individual AVM and is tailored to your specific case.

Treatment of a brain AVM will usually involve combined treatments performed by an Interventional Neuroradiologist and a Neurosurgeon, depending on its size and location. The Interventional Neuroradiologist usually performs an embolization prior to a surgical procedure.

Treatment of a dural AVM does not usually involve an additional surgical procedure. The Interventional Neuroradiologist can usually block the involved blood vessel, either the artery or the vein, to cure the problem.

What Should I Expect?

Prior to your procedure, you will have a thorough consultation with our Neuroradiology Nurse Case Manager and one of our Interventional Neuroradiologists. All possible treatment options will be reviewed and discussed with you in detail, and all of your questions will be answered. If embolization of your AVM is the treatment of choice for you, Radiology Ltd. will make the necessary arrangements for you.

After registering at the hospital, you will be sent to the Special Procedures Area, where you will have an intravenous (IV) line placed in your arm and a tube (Foley catheter) placed into your bladder. Fluids and pain medication will be given prior to your procedure. You will then be sent to the Interventional Suite in the Department of Radiology, where you will meet with your doctor (Interventional Neuroradiologist) and the nurses and technologists trained in this procedure. For treatment of a brain AVM, you will undergo general anesthesia and will be asleep throughout the procedure.  For treatment of a dural AVM, you will be given sedation for relaxation and discomfort but will be conscious during the procedure.

A catheter (small tube) will be advanced into the femoral artery located in your groin region and then advanced into the arteries leading to your brain. An angiogram will then be performed, in which images of the blood vessels are obtained during an injection of iodine-based contrast material.  Once the abnormal connection between the artery and vein is well visualized, the embolization will be performed. At the end of the procedure, the catheter will be removed. You will usually be observed in the hospital overnight. Most patients go home the next day and can return to normal activity within a couple of days.

Significant complications related to AVM embolization are uncommon. The primary risks associated with this procedure include:

  • Groin hematoma or bruising
  • Allergic reaction to the contrast material
  • Stroke
  • Bleeding

For your safety and the protection of others, we do not allow anyone other than patients in our exam rooms.

Who Will Be Performing My AVM Embolization?

Your procedure will be performed by Dr. Ashdown, Dr. Gyorke, Dr. Jeck, or Dr. Rucker, all of whom are Senior Members of the American Society of Interventional and Therapeutic Neuroradiology (ASITN). They are trained in all aspects of AVM embolization and are very experienced as members of one of the most successful Interventional Neuroradiology practices in the country.

For more information or clinical questions, please call Faith Johnston at (520) 901-6616.

To schedule a consultation, please call Tracey Bassett at (520) 873-3724.

Interventional Radiology Team

Boyd C. Ashdown, M.D.

  • Specialties:
    Interventional Neuroradiology, Neuroradiology
  • Education:
    B.S. – University of Wyoming, 1985
    M.D. – University of Utah, 1989
  • Internship:
    General Surgery, St. Joseph Hospital (Denver), 1989-1990
  • Residency:
    Diagnostic Radiology, Duke University, 1990-1994
  • Fellowship:
    Vascular/Interventional Radiology, University of Washington, 1994-1995
  • Board Certifications:
    ABR 1994; CAQ Neuroradiology 1999, 2009

With Radiology Ltd. since 1995

Andrew Gyorke, M.D.

  • Specialties:
    Interventional Neuroradiology, Neuroradiology
  • Education:
    B.S. – California Polytechnic State University at San Luis Obispo, 1981
    A.D. – University of Uppsala (Uppsala, Sweden), 1978-1979
    M.D. – George Washington University (Washington, DC), 1986
  • Internship:
    General Medicine, George Washington University (Washington, DC), 1986-1987
  • Residency:
    Diagnostic Radiology, Tufts New England Medical Center (Boston), 1987-1991
  • Fellowship:
    Interventional Neuroradiology, University of Utah, 1991-1993
  • Board Certifications:
    ABR 1991

With Radiology Ltd. since 1999

David T. Jeck, M.D.

  • Specialties:
    Interventional Neuroradiology, Neuroradiology
  • Education:
    B.A. – University of Pennsylvania, 1991
    M.D. – University of Arizona, 1995
  • Internship:
    Transitional, Good Samaritan Regional Medical Center (Phoenix), 1995-1996
  • Residency:
    Diagnostic Radiology, Mallinckrodt Institute of Radiology (St. Louis), 1996-2000
  • Fellowship:
    Neuroradiology, Mallinckrodt Institute of Radiology (St. Louis), 2000-2002
  • Board Certifications:
    ABR 2000; CAQ Neuroradiology 2002, 2012

President, Radiology Ltd.
With Radiology Ltd. since 2002

Creed M. Rucker, M.D.

  • Specialties:
    General Radiology, Interventional Neuroradiology, Neuroradiology
  • Education:
    B.S. - University of Arizona, 1995
    M.D. - University of Arizona, 2000
  • Internship:
    General Surgery, Vanderbilt University Medical Center, 2000-2001
  • Residency:
    Nuclear Medicine, Vanderbilt University Medical Center, 2001-2002
    Diagnostic Radiology, Washington University School of Medicine, 2002-2005
  • Fellowship:
    Interventional Neuroradiology, Washington University School of Medicine, 2005-2007
  • Board Certifications:
    ABR 2006

With Radiology Ltd. since 2015

Meet Dr. Gyorke, Tucson physician

Arteriovenous malformation (AVM) is an abnormal connection between arteries and veins that bypasses the capillary system. Although many AVM’s are asymptomatic, they can cause bleeding or lead to other serious medical problems. An embolization is a specialized, controlled blocking of the blood supply to the AVM with coils, particles, or glue. Dr. Ashdown, Dr. Gyorke, Dr. Jeck and Dr. Rucker, are trained in all aspects of neuroembolizations, and perform these procedures for Radiology Ltd. in Tucson.