Arteriovenous Malformation Surgery - Costs, Health Benefits And Risks

Arteriovenous malformation (AVM) is a vascular pathology that typically arises during prenatal development. Although the condition is congenital, it is not inherited. Children of the parents with AVM have the save risk of its development as the whole population. The incidence of AVM reaches 1 in 100,000.

The basis of the disease is the typical connection between arteries and veins. Normally, large arteries start from the heart and contain oxygen-rich blood. Carrying blood through the body, they gradually turn into the capillaries and then into veins. Capillaries provide nutrient exchange and supply tissues with oxygen. In AVM there are no capillaries and arteries are connected directly to veins.

Such irregular connections between the blood vessels hamper normal metabolic processes in the tissues. In addition, AVM vessels are fragile and often rupture causing life-threatening bleeding. Surgical reconstruction of the affected area is the only way to avoid all the health risks.

AVM Diagnosis

Arteriovenous malformations most often develop in the spinal cord, on the brain surface or inside of it. Small AVMs may be totally asymptomatic and not disturb a person throughout life. Being located in significant brain regions or having a large size, they cause a number of complaints. You should seek medical help in the presence of such symptoms

• The weakness of muscles or one-sided paralysis
• Weakness in the legs or back pain
• Sensitive disorders, e.g. tingling or numbness
• Seizures
• Memory deficit, difficulty speaking
• Loss of coordination

At the beginning of the visit, your neurologist will ask you about the symptoms and concomitant conditions. Then he will proceed to the physical examination. Having this basic information, the doctor will recommend one or few instrumental examinations in order to specify the diagnosis

• Computed Tomography (CT) brain scan creates a detailed image of the brain with the help of X-rays.
• Magnetic Tesonance Imaging (MRI) brain scan is a more sensitive technique. It uses magnets and radio waves, providing a doctor with information on the location of the malformation and presence of bleeding from its vessels.
• Cerebral arteriography demonstrates the exact picture of the brain vessels. It is possible due to injecting the special dye that is perfectly visible for X-rays.

Types Of Radical Treatment

Conservative drug therapy can alleviate the disease manifestations (e.g. seizures or headache), but cannot influence the root cause of the condition – changes in the vessel structure. Only direct surgical intervention is a totally curative measure that provides long-term results.

1. Conventional Surgical Treatment is suitable in urgent situations (e.g. in the life-threatening bleeding from the brain vessels) or in case of small superficial AVMs. During the intervention, a surgeon opens the skull, puts special clips of the afferent and efferent AVM vessels, and carefully removes the pathology. After that, the skull is closed and the patient is carefully monitored in the ICU.
2. Endovascular Interventions include embolization and coiling with platinum coils. These are more sparing for the brain options, as they do not require the skull opening and cutting the brain tissue. Treatment is performed “from the inside”, via the blood vessels. AVM volume is reduced with the help of platinum coils or a glue-like substance, which sticks together vessels walls.
3. Radiosurgical Interventions, Despite its name, stereotactic radiosurgery is a non-invasive treatment option. The AVM is destroyed with the help of highly targeted radiation beams. The high energy of the beams ruins blood vessels and prevents hemorrhage the same time. This method is applied in case of small AVMs located in the hard-to-reach brain regions.

Benefits Of Treatment Abroad

When we talk about the treatment abroad, we mainly imply that the patient chooses the best-specialized hospital regardless of the origin country. Fortunately, nowadays you can receive medical treatment in any hospital you want, provided that you have sufficient funds or good health insurance.

AVM treatment abroad targets three key pathological mechanisms

1. Risk of hemorrhage.
2. Compressing the surrounding brain or spinal cord tissue.
3. Hampering oxygen supply to the nervous tissue.

These allow eradicating all present symptoms and possible risks. The second one is of great importance as well, as about 4 out of 100 patients with AVM experience a hemorrhage annually.

Other benefits of treatment in the leading European hospitals include

• Preference for minimally invasive techniques which provides short hospital stay.
• Low risk of complications (e.g. neurological deficit, bleeding, infection).
• Low risk of the disease recurrence.
• Good cosmetic results (avoiding visible scars or head deformity).
• Individual rehabilitation programs and full restoration of all skills.
• High level of comfort during the hospital stay.

How To Estimate The AVM Surgery Cost

Costs of the surgery always exceed expenditures on the drug treatment. Nevertheless, surgical treatment provides long-lasting effect, while drugs can only mask the symptoms and require the lifelong intake.

Basically, the AVM surgery cost depends on the type of intervention. Approximate prices for the treatment in the leading European hospitals are the following

• Precise preoperative diagnostics and the treatment planning – from 2,281 €.
• Radiosurgical treatment with Gamma knife – from 10,469 €.
• Surgical treatment with partial resection of the malformation and the subsequent coil placement – from 21,232 €.
• Endovascular treatment with embolization or the platinum coils placement – from 16,415 €.

In addition, the price may be higher if a patient chooses the VIP room or wants to be treated by the head physician. Such an option may not be covered by the insurance, so it is better to discuss all the aspects with your insurance company in advance.

Arrangement Of AVM Treatment Abroad

The first stage of planning treatment abroad is investigating the information about clinics, doctors and their success rates. Finding reliable data is not always easy, as there is a lot of advertising information. Reviews of other patients will be helpful but somewhat subjective, as every clinical case is individual.

The safest and convenient way of undergoing AVM surgery abroad is using the help of Booking Health. Booking Health is the certified medical tourism operator that has been involved in arranging treatment of patients from 75 countries for over 15 years. Booking Health specialists will guide you through the whole treatment process with confidence

• Assist in hospital and surgeon selection.
• Give advice on the most effective treatment option, prepare the preliminary treatment plan.
• Provide you with the invitation for treatment and book the convenient appointment date.
• Provide the unbiased monitoring of the medical program.
• Take care about fare costs for medical services, excluding extra fees for the foreigners (saving up to 50%).
• Control of all invoices and return of unspent funds.
• Organization of additional procedures and rehabilitation, if necessary.
• Booking accommodation and plane tickets, transfer organization.
• Offer services of a medical interpreter, who will be with you in the clinic.