An arteriovenous malformation (AVM) is an abnormal connection between an artery (a blood vessel carrying blood from the heart out to the body) and a vein (a vessel returning blood to the heart).
It's a shortcut that lets blood flow from an artery to a vein without passing through tiny vessels called capillaries. That's important because oxygen and other nutrients can only pass from the blood into the body parts that need them in capillaries.
Blood that takes a shortcut through an AVM returns oxygen-rich blood to the heart instead of delivering it to the body where it's needed. That means some of the heart's work is wasted, so the heart has to work harder than usual. Large AVMs or multiple AVMs can waste so much of the heart's work that it cannot keep up.
A child with an AVM may have these symptoms:
Many AVMs, especially those in the head, are not recognized until adulthood. AVMs in the head may cause:
Bleeding from an AVM can be hard to stop. Frequent bleeding may lead to anemia. Even small amounts of bleeding from an AVM inside the skull can be very dangerous. AVMs may grow larger and cause trouble by pressing on other parts of the body.
Arteriovenous malformations and venous malformations are types of vascular malformations (also called vascular anomalies). These are problems that happen when blood vessels (capillaries, arteries, veins, or lymphatic vessels) don't develop as they should.
Doctors don't know what causes AVMs. Kids who have them are born with them, and an AVM might get larger as the child grows.
AVMs can happen with some genetic syndromes, including:
An AVM is often found during an exam because a pulse may be felt in its vessels. Then, other tools may be used to learn more about it and plan treatment, such as:
The right treatment for an AVM depends on its location, size, and how it affects the child.
When a child's heart must work harder than usual because of an AVM, prompt treatment is important to prevent permanent changes. An AVM also might be treated to improve pain, bleeding, or its appearance.
AVMs in the arms, legs, and body are easier to treat than AVMs in the head.
AVMs outside of the skull are treated with:
AVMs in the head are called intracranial AVMs and may be treated with embolization, surgery using radiation (radiosurgery), or surgery.
Embolization and sclerotherapy usually are done by interventional radiologists (doctors who specialize in minimally invasive, targeted treatments).
Treatment for an AVM depends on its location, size and the symptoms it causes. A small AVM that's not in the head may never need treatment, but it could change as a child grows. Some AVMs get bigger, so it's important to track its size and its effects on a child's health and activities.
Reviewed by: Annie Kyoung Lim, DO
Date Reviewed: 14-11-2017