Brain AVM Embolization with Onyx By Sibasankar Dalai

[sibadalai77]

There are many reasons for a person to have seizure. AVM is one of them.

You must have an MRI of the brain with MR angiogram done to rule out an AVM or a space occupying lesion. once u have an MRI- we can mostly diagnose an AVM.

Once an AVM is diagnosed in the MRI, We can do an angiogram of the brain (DSA) to characterize the lesion, study the angio-architecture and plan the treatment.

[morshalin78]

I am a 37 years old, 5'-6", 66kg weight man. In March, 2008 my first

seizure was held. So far 22 times seizures held. Every time seizure

held at night, but 2 or 3 times at day. Before seizure I realize

nothing. After holding seizure a deep sleep come and when I awake from

sleep, I feel pain in my head, hand, leg and cut of my tongue and

weakness. Asking someone I am confirmed I was attacced by seizure.

Doctors say this is for AVM. How will I do now?

[sibadalai77]

Dear Dr.Leoman,

Thank you for your advice/suggestions.

We take informed, written consent of patients before using the images/videos on

any public forum.

The video is purely educational for trainees in Interventional Neuroradiology or any other physician interested in such procedures.

Further feedback ll be appreciated.

[drleoman]

Dr Dalai, please be careful about patient confidentiality issues before posting videos,its a law suit in waiting,also soliciting practice this way is unethical,good luck.

[binupallickal]

Thanks Doctor. I will Call u.

[binupallickal]

Dear Doctor, I am working in dubai. Tomorrow I send you my angiogram pictures.

help me doctor.

Thank you so much

[sibadalai77]

i ll look into that..

[sibadalai77]

You have a moderate flow, medium sized, right frontal AVM.

Embolization was attempted. Embolization is incomplete (Last image of your angiogram: shows

residual filling of the AVM nidus with early opacification of the draining vein along with the cast).

It needs to be treated. It can be very safely and completely treated by embolization.

[binupallickal]

Dr. 2 month ago i got avm. after that i do embolisation. now i am ok or not? what I wand do?

[sibadalai77]

We need to see the angiography before and after the embolization to ensure

that you AVM is completely embolized.

An angiographic cure almost always means you are cured of the AVM for life.

If the AVM is not embolized completely, then we have to look at it further.

Please send me your angiogram pictures (Before & after the embolization).

[cvknrao]

In my view, Embolisation is not always the complete cure for AVM. The natorious nature of AVM associated with NeoAngiogenetic vessels could reapper the AVM. making the residual AVM as dangerous as the original one. Embolisation in Some caes its absolutely suitable and beneficial for some others. But the araising micro fistulla growth could also to be seen while selecting the management technique for typically large/ gaint AVM's.

[sibadalai77]

True, Embolization is not always the complete cure for AVM.

However, if an AVM nidus if completely embolized, AVM almost never comes back again. The risk of the AVM mostly depends on the angio-architecture of the nidus (intranidal fitula, intranidal aneurysm, aneurym in the feeding artery, long-tortuous daring vein etc) and size. Finally, AVM should be managed with one or the combination of the techniques like embolization, surgery, gamma knife etc.

[cvknrao]

Yes....Truely correct. My wife was diagnosed with gaint AVM in the left parieto, temperal and occipetal regions sizing over 7.6 cm. She had under gone three embolisations in the year 1995, 1996, 1997 and a gamma knife in 1997 and embolisation in 2010. AVM is really very very natorious...and one has to be very very carefull in its management.

[mattlewis99]

would it be possible to have your email address and i can send you some photos for you to look at? any help with my situation is appreciated deeply. thank you for your help so far, much appreciated

[sibadalai77]

At the end of the video u can find my website.

please go to the contact and mail me.

[mattlewis99]

what is the success rate of this procedure? i have a AVM in my lip, and my doctor has recommended this....

[sibadalai77]

The success of the procedure depends on the nature of the lesion. Onyx embolization is a very successful procedure for treatment of small & medium sized brain AVM and partially targeted embolization of the large/hemispheric AVM. However lip AVM is a different disease altogether. Glue (Hisoacryl) is also a good embolizing material for lip. Size, vascularity & extend of lip AVM with a photograph of the AVM will be definitely helpful for me to comment further.

[sibadalai77]

Thank You Deepak

[drdeepakpadhi]

Great work Bhai,keep up the name of Orissa by more such brillaint activities.