What is an arteriovenous malformation?

VCU Baird arteriovenous malformation

Arteriovenous malformations (AVMs) are defects in the vascular system, most easily described as an abnormal tangle of blood vessels connecting arteries and veins.

The vascular system includes arteries, veins, and capillaries. Arteries carry oxygen-rich blood away from the heart to other organs; veins carry oxygen-depleted blood back to the heart. Capillaries connect the arteries and veins. With an AVM, the tangle of arteries and veins disrupts normal blood flow and oxygen circulation.

According to the Mayo Clinic, when an AVM disrupts this critical process, the surrounding tissues may not get enough oxygen, and the affected arteries and veins can weaken and rupture. If the AVM is in the brain and ruptures, it can cause bleeding in the brain (hemorrhage), stroke or brain damage. While AVMs in other areas of the body are generally not a serious health concern, they can often be inconvenient, painful and unsightly.

AVMs can happen anywhere, but they are more common in the brain or spinal cord. Most people with brain or spinal cord AVMs have few, if any, major symptoms. Sometimes they can cause seizures or headaches.

It’s not clear what causes of AVMs. However, researchers believe most people are born with them, but they can occasionally form later in life. While it’s a rare condition to be passed down among families, there are several rare genetic diseases that are associated with AVMs.

AVMs treated at Baird Vascular Institute at VCU Health include those of located on the extremities as well as various locations on the body including the pelvic region. The Interventional Radiologists and Vascular Surgeons at BVI are well equipped to treat these AVMs. Our capabilities also allow us to handle the primary treatment of AVMs that once may have required prolonged hospitalizations. Today, our image-guided expertise makes outpatient care of these conditions possible. Depending on the location and severity of the AVM, we can generally treat these on an outpatient basis by injecting a sclerosing agent – similar to how we might treat some varicose veins. This has the effect of essentially collapsing the vein(s) and having it stick together which prevents blood flow into that area. The body then naturally reroutes blood flow through other vessels to compensate and to keep surrounding tissue healthy.

If you are concerned and think that you may have an AVM, or you have recently been diagnosed with an AVM and would like to speak with us about your options, give us a call at 804-828-2600.



Why would someone need a vascular ultrasound?

Vascular ultrasound is a noninvasive ultrasound method used in vascular screening to evaluate your blood circulation. A vascular ultrasound may also be called a duplex study since it combines traditional ultrasound and Doppler ultrasound.

  • Traditional ultrasound uses sound waves that bounce off blood vessels to create pictures.
  • Doppler ultrasound records sound waves reflecting off moving objects, such as blood, to measure their speed and other aspects of how they flow.

Ultrasound is noninvasive, meaning the vascular screening exam does not require the use of needles, dyes, radiation or anesthesia. Ultrasound imaging uses a small transducer or probe, and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image. Since different tissues of the body, such as muscle, bone, and blood vessels have different densities, they show up differently on the image.

Your physician may recommend that you have this vascular screening exam to evaluate the blood flow to specific organs in your body. Vascular ultrasound can be used to evaluate:

  • Blockages to blood flow, such as clots
  • Stenosis or narrowing of vessels, which may be caused by plaque or emboli
  • Tumors, congenital vascular malformations or aneurysms
  • Blood flow to organs and tissues throughout the body
  • Confirm that a blood vessel graft or bypass is working properly
  • Source and severity of varicose veins

Ultrasounds are generally quick and virtually pain-free. The technologists at the VCU Health at Baird Vascular Institute are highly skilled and certified to perform vascular screening ultrasound exams. They work in close collaboration with our physicians to provide the most accurate and useful imaging possible to help diagnose and treat your condition.


I’ve been told I need dialysis. What can VCU Health at Baird Vascular Institute do for me?

At the VCU Health at Baird Vascular Institute, our experts are uniquely equipped to deal with the maintenance and care of your dialysis access in a convenient, neighborhood setting. With the latest technology and highly skilled staff, each case is approached as a unique and individual patient, complete with plans of care and follow-up.

If you are starting hemodialysis treatments in the next several months, one crucial step before starting regular hemodialysis sessions is preparing a site on the body to access the vein. Dialysis access is the site on your body where blood is removed and returned during dialysis. To maximize the amount of blood cleansed during hemodialysis treatments, dialysis access should allow continuous high volumes of blood flow.

There are three access options for the dialysis patient – AV fistula, AV graft or a central venous catheter.

To allow for the high volume of blood exchanged, dialysis access to your blood is usually in your arm or leg. Choosing your access is a decision that you and your doctor will make.

Here is some additional information about your options.

AV Fistula

An AV (arteriovenous) fistula is a surgical connection of one of your own arteries to a vein under the skin of your arm. It’s the most natural dialysis access because it’s made with your own blood vessels. Most people can tolerate an AV fistula. However, if your veins are too small or too weak for a fistula, there are other options.

An AV fistula requires advance planning because the fistula takes a while to develop, or mature, after surgery, — in rare cases, as long as 24 months. However, a properly formed fistula is less likely than other kinds of vascular access to form clots or become infected. Also, properly formed AV fistulas tend to last many years—longer than any other type of dialysis access.

AV Graft

An AV graft is a surgical insertion of a special tube that connects to a vein and an artery. It becomes an artificial vein and is used like a fistula. If you have small blood vessels that won’t develop into a fistula, an AV graft may be a good option for you.

An AV graft doesn’t need time to mature as a fistula does, so it can be used sooner after its placement, often within 2 or 3 weeks. Compared with properly formed AV fistulas, AV grafts tend to have more problems with clotting and infection, and need replacement sooner. However, a well-cared-for AV graft can last several years.

Central Venous Catheter

If your kidney disease has progressed quickly, you may not have time to get a permanent dialysis access before you start hemodialysis treatments. You may need to use a central venous catheter as a temporary access. A catheter is a tube inserted into a vein in your neck, chest, or leg near the groin.

Central venous catheters are not ideal for permanent access. They can clog, become infected, and cause narrowing of the veins in which they are placed. But if you need to start hemodialysis immediately, a central venous catheter will work for several weeks or months while your permanent access develops.

For some people, AV fistulas or AV grafts are unsuccessful and they need to use long-term catheter access. Central venous catheters that will be needed for more than about 3 weeks are tunneled under the skin to increase comfort and reduce complications. However, even tunneled catheters are more prone to infection than AV fistula and AV grafts.

Your healthcare team will help you choose the best long-term dialysis access for your situation. If you already have an AV fistula/AV graft that is not functioning properly, or if you need a central venous catheter, speak with your doctor and contact us. We can diagnose and treat you to get your access functioning. Please contact us at (804) 828-2600 or email us at bairdvascularinstitute@mcvh-vcu.edu.

What other services does VCU Health at Baird Vascular Institute offer besides port procedures?

Baird Institute

You can take advantage of our world-class medical services in a convenient neighborhood setting. Our interventional radiologists and vascular surgeons offer a multidisciplinary approach to vascular disease so that each patient receives a comprehensive vascular screening and a treatment tailored to his or her particular need. The institute affords patients easy access to the full array of expert vascular screening and treatment services offered by the VCU Health.

We offer many minimally invasive services beyond our port procedures, including:

At the VCU Health at Baird Vascular Institute, we have the latest in technology and techniques to diagnose and treat vascular disease. If we uncover signs of vascular disease, our experts can develop a custom treatment plan for you.

How is Baird Vascular Institute affiliated with VCU Health?

Every day, there’s a new discovery at VCU Health. Whether it’s a patient who undergoes a new, life-saving procedure or a clinical researcher who finds promise in a new cancer treatment, exciting medical advances are taking place. As the only academic medical center in the region, VCU Health is on the forefront of health care, providing patients with the most progressive treatments and medical technology available.

For the third time, VCU Health has been ranked a #1 hospital in Virginia and the Richmond metro area by U.S.News & World Report®. Thanks to the dedication, compassion and expertise of its more than 11,000 team members — from doctors, nurses and resident medical staff to support personnel and administrators — the medical center also enjoys consistently high patient satisfaction ratings.

The interventional radiologists and vascular surgeons of VCU Health teamed up to create a unique and exciting service for patients in Central Virginia. By combining the experience and expertise of these two areas, these skilled physicians offer the very best in vascular care for the Greater Richmond area at Baird Vascular Institute. Our state-of-the-art facility offers customized vascular care tailored to the individual needs of each patient — set in a warm and friendly environment located conveniently just off Interstate I-195.

VCU Health at Baird Vascular Institute is unique in that it combines the very best expertise and knowledge of a prominent academic medical center with the convenience of an outpatient clinic. Designed to be patient friendly and easily accessible, the Baird Vascular Institute provides patients with a comfortable setting for the diagnosis and treatment of many vascular conditions.

What exactly is an Interventional Radiologist?

The VCU Baird Vascular Institute’s medical director, Dr. Malcolm Sydnor, uses fluoroscopic guidance utilizing the latest in interventional technology.

The VCU Baird Vascular Institute’s medical director, Dr. Malcolm Sydnor, uses fluoroscopic guidance to treat a patient with a vascular problem.

Many of the physicians at VCU Baird Institute are Interventional Radiologists. You may have wondered about our specialty, so allow us to explain a bit more.

Interventional Radiologists are specially trained to use minimally invasive, image-guided techniques to diagnose and treat a variety of issues within the human body. The goal is to use the least invasive treatment plan required in order to address the issue, avoid risk to the patient and impact on the body and to speed recovery time. Many times, interventional radiologists are able to treat an issue with less risk, less pain and less recovery time than traditional open surgery.

Interventional radiologists use a variety of tools such as ultrasound, X-ray, CT and MRI technology to target medical issues within the body.

Recognized as a medical specialty by the American Board of Medical Specialties, interventional radiologists are board-certified physicians with additional advanced training in minimally invasive, targeted treatments performed using imaging to guide them. Their board certification includes both Vascular and Interventional Radiology and Diagnostic Radiology, which are administered by the American Board of Radiology.

Interventional radiologists pioneered many of the non-invasive techniques that are commonly used today, such as angioplasty and the catheter-delivered stent. Trained in both radiology and interventional therapy, interventional radiologists possess a combination of skills that are unique to their specialty. Today, an interventional radiologist can treat many of the procedures that once required surgery with a less invasive treatment option.