As many of you know, my treatment for my brain AVM has been a long and upsetting journey. I had the Gamma Knife after a bleed, then a failed artery embolization, Gamma Knife again, another bleed, failed venous embolization, then a third Gamma Knife. All of this was in Canada, where I live. It has been almost three years since my last Gamma Knife. My MRI scans are showing a vein, and my doctor wants me to go to the city next year for another MRI. (He isn’t confident in the images from my local small-town hospital.) My partner suggested getting another opinion in the USA. Are there any treatment options they offer there that they don’t perform in Canada? I don’t know yet if I need to go this route, next year’s MRI will give me more information. Invasive surgery was never an option because of the location of the AVM.
I’m just asking if there are any treatments, maybe not offered in Canada, that would help destroy the AVM? Just want to explore options for the worst-case scenario. Thank you.
I don’t think there are any different treatment options, but there is some very experienced AVM clinics, Barrows, UCLA, Mayo in Rochester is very highly rated, Cleveland Clinic just to name a few. I would guess anyone would want confidence in the MRI, when is the last angio you had? Take Care, John.
My last angiogram was February 2021, during the attempt at venous embolization. That’s when the doctors realized there were two veins feeding out of the AVM. I’ve had my surgeries at Toronto Western Hospital, and that’s where my doctor wants to follow up next year.
My experience at Toronto Western Hospital has been excellent.
I’ve described in detail to this group all three of my surgeries, the last being the Gamma Knife, when the obliteration of my two previous surgeries of my AVMF were not successful.
They used then 20 coils on my first, then glue on the second to finally resolve my drama with the Gamma Knife on the third intervention.
Dr. Cussimano is the team leader.
Dr. Marotta, the head of my first and second surgeries.
Dr. Schwartz, the Gamma Knife leader. He called me to give me the happy report of their success in the final eradication of my AVMF.
My gratitude to all the participants of my treatment.
In my opinion, they are very knowledgeable in their specialty.
Thanks for your response. I also am being treated by Dr. Schwartz; he has performed all three Gamma Knife surgeries. I agree that they are excellent doctors in Toronto.
Barrow in Arizona does give remote consults you might try that and see if what they think. Dr Michael Lawton is considered the top Dr in the USA he used to be at UCSF and I have seen his work. My Dr has retired from Stanford and when I need any more work I will be going to Dr. Lawton. I could of gone to him at the beginning but I was already at Stanford seeing the head of stroke due to five blood clots that latered caused the DAVF and the head neuro in pain. So it was just easier to navigate the system.
I agree. One thing that is not too expensive to do is to ask any of the major US neurosurgery practices for a “remote second opinion”.
I also agree with John that I haven’t seen anyone with a brain AVM having any radical/different treatment than is available across most other countries: it all consists of the three main options of open surgery, endovascular embolization or radiotherapy of one kind or another.
I agree that there are no differences in terms of treatment options. The difference that is significant is experience of Neurosurgeon when dealing with treatments and latest technology. Precision in Gamma Knife can matter between hitting the target only or also healthy brain tissue. Embolization experience matters between getting a stroke or not. Therefore always look for top doctors with top technology and staff. It does matter who touches your brain.
