The Assurance You Need for Arteriovenous Fistulas
Understanding as much as you can about your neurovascular condition helps you feel more confident as you navigate treatment. Neurovascular conditions like arteriovenous fistula (AVF) aren’t easy to face, but you can rest assured that your care team within the AdventHealth Neuroscience Institute network will do all they can to keep you informed during every phase of your treatment, from the initial diagnosis through treatment and beyond.
We believe that expert care means more than state-of-the-art technology and world-renowned specialists. When you ask questions about your AVF diagnosis and treatment, we’ll give you answers, helping you make informed decisions so you can feel as comfortable as possible. At every step, we'll work to heal your body, ease your mind and lift your spirit, too.
What to Know About Arteriovenous Fistula
- What Is an AV Fistula?
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An arteriovenous fistula (AVF) is easier to understand if we break the name down into parts. “Arterio-” refers to your body’s arteries, and “-venous” refers to your body’s veins.
In a healthy vascular system, arteries carry blood away from the heart and veins carry blood to the heart. This cycle of blood is how your body and all of its organs receive oxygen and nutrients. Arteries and veins don’t connect. Instead, tiny blood vessels called capillaries connect the veins and the arteries and help maintain normal blood flow.
A fistula is two things that are abnormally joined. In the case of an AVF, a fistula is a place where an artery and a vein are abnormally joined without the capillary connectors. When blood is diverted in this way, it isn’t flowing through the body correctly. Certain parts of your body may not receive the oxygen and nutrients they need.
- Are There Different Types of Arteriovenous Fistula?
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Because your blood vessels flow throughout your body, there are many places an abnormal connection can form, meaning there are several types of arteriovenous fistulas.
Two common nervous system arteriovenous fistulas are:
Arteriovenous Malformation
An arteriovenous malformation is similar to an arteriovenous fistula but develops within the brain and spinal cord tissue itself. Learn more about this specific condition.
Dural Arteriovenous Fistula (dAVF)
Near the brain, an arteriovenous fistula can develop around the dura mater, a protective layer that surrounds your brain’s cushioning and carries blood from your brain to your heart. Dural arteriovenous fistulas usually develop later in life, though they can still affect the youngest of patients and can lead to serious complications like heart failure, learning disabilities and problems with speech and memory. Hearing issues, vision problems and eye bulging or swelling are all dural arteriovenous fistula symptoms.
- What Causes Arteriovenous Fistula?
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Arteriovenous fistulas are caused by either genetics — though they are rarely passed from parent to child — or tissue separation:
- Genetics: Some babies are born with a condition that causes blood vessels to develop abnormally, like Osler-Weber-Rendu disease
- Tissue separation: Certain injuries — like stabbings, gunshots or damage that results from a complication from a procedure like cardiac catheterization — can cause tissue separation
- Common Brain and Spine AV Fistula Symptoms
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Common symptoms of AV fistulas include:
- Tinnitus (ringing in the ears)
- Headaches
- Vision changes
- Bleeding into the brain
- Weakness in the legs
- Back pain
- Numbness
- Diagnosing an AV Fistula
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The process of diagnosing an AV fistula in the arms or legs is relatively easy. Since these AVFs produce visible signs, your doctor can usually use a stethoscope to listen to the blood flow at the site of the enlarged vein or artery. The diagnosis can be confirmed with special imaging procedures that inject dye into the body, allowing the doctor to see if blood is bypassing the capillaries.
Diagnosing an AVF that has no visible signs can be more difficult. It’s essential that you pay close attention to your body and let your doctor know if you notice anything out of the ordinary, such as unexplained bleeding, general fatigue or a sudden drop in blood pressure. Detecting an AVF early is the best way to prevent serious complications like heart failure or even stroke.
The best way to definitively confirm the presence of an AVF is through a diagnostic angiogram.
- Treating an AV Fistula
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If your AVF has high-risk features, it may require treatment. The complexity of treating these blood vessel abnormalities requires evaluation and discussion with doctors specially trained in brain and spine blood vessel procedures. Some AVFs may not require any treatment at all.
Catheter Embolization
A catheter embolization, or endovascular embolization, is the most common AV fistula surgery. During this minimally invasive procedure, the doctor will use a catheter to access the fistula. Next, a blocking material such as a plug, glue or a tiny balloon will be threaded to the fistula and used to close the connection between the vein and artery. Most people can go home the day after embolization.
Stereotactic Radiosurgery
Using a specialized machine, we can administer a highly accurate dose of radiation to the AVF. This forces the abnormal blood vessels to close over time.
Minimally Invasive Brain Surgery
Specialized neurosurgeons may be required to perform a focused and tailored surgery to remove the AVF directly.
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