What is Vascular Malformation?
A vascular malformation is an abnormal collection or tangle of blood vessels on, in, or near the spinal cord. Two of the most common types are arteriovenous malformations (AVMs) and arteriovenous fistulas (AVFs).
AVMs are caused when oxygen-rich blood, which normally enters your spinal cord through arteries and blood vessels, bypasses the blood vessels, or capillaries, and passes directly into the veins. The spinal cord doesn’t receive enough oxygen and causes spinal tissues to deteriorate or die. Sometimes the spinal AVM can rupture, causing bleeding in the spinal cord. As AVMs grow, they may put pressure on the spinal cord.
AVFs account for 70 percent of all spinal vascular malformations and usually appear in the thoracic (mid back) spine near the nerve root. They are caused by an abnormal connection between arteries and the tough covering over the spinal cord and a draining vein. AVFs create congestion in the veins and hypertension, resulting in decreased blood flow through the organs, oxygen depletion, and swelling of the spinal cord.
At UPMC we treat several treatments for vascular malformations on the spine. Depending on the location of the malformation, surgeons may recommend resection surgery, endovascular embolization, or a combination of both. Surgery involves the removal of the malformation from the surrounding tissue. In endovascular embolization, the surgeon threads a long thin tube into an artery in the leg through the blood vessels to the spinal cord using x-ray imaging. A substance is injected to block the artery and reduce blood flow to the malformation.