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An Amazing Journey: Minimally Invasive AVM Treatment

Dr. Sandra Narayanan is a stroke neurologist and interventional neuroradiologist at Detroit Medical Center (DMC). This specialty takes her not only inside the human body, but deep inside the veins of the brain, to treat Arteriovenous malformation (AVM.) AVM is a naturally-occurring defect in the veins that serve the brain. It can happen elsewhere in the body, wherever there are blood vessels, but Dr. Narayanan specializes in AVMs of the brain and spinal cord.



These abnormalities in the vascular channels to the brain steal blood supply from the normal surrounding brain tissue. This lack of blood supply can cause strokes. AVM can also cause headaches and even a hemorrhage in the brain. In the case of Darrell Rigsby, it caused seizures.


Darrell woke one night with a cramp in his leg, and quickly fell into a seizure that lasted 35 minutes. When a patient like Darrell suffers from an AVM, Dr. Narayanan steps up to treat them with endovascular means – feeding a thin catheter through the femoral artery in the groin and tracking its progress under x-ray guidance. The catheter travels on an amazing journey through the arteries of the abdomen, chest and neck, until it reaches the artery that is supplying the vascular malformation in the brain.


A small dose of liquid is then injected, to create the contrast needed to see which arteries are supplying the tangled blood vessels. Once identified, the doctor injects a glue-like substance to close the blood vessels supplying the malformation, to cut down the blood supply to the AVM.


Smaller AVMs can be treated successfully using this minimally-invasive method. Larger AVMs may be treated this way first, to reduce the blood flow, and then moved to a second stage, usually surgery.


“If there are no issues during the procedure – which is the vast majority of these patients – they spend one night in the intensive care unity and are discharged home the following day,” says Dr. Narayanan. “The recovery time is quite good, and they are soon back to their normal routine. Darrell Rigsby seconds that notion, saying “My recovery has been great. I haven’t had any problems.”


Find out more about/request an appointment with Dr. Narayanan.

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