Teen girl treated for rare vascular malformation in Gurugram

Medanta Medicity doctors said the case highlights the expanding role of image-guided interventions in managing high-flow AVMs, especially during high-risk surgeries.

A 16-year-old girl diagnosed with a rare congenital vascular disorder called arteriovenous malformation (AVM) was recently treated using a minimally invasive technique in Gurugram. In this disorder arteries connect directly to veins without capillaries, causing pain and swelling.

EVOH is an embolic agent, which offers slow, controlled delivery and deep penetration into the nidus (core) of the AVM.

The girl suffering from peripheral vascular lesions in her right buttock was treated using a technique involving ethylene-vinyl alcohol copolymer (EVOH) —a liquid embolic agent typically used for complicated neurovascular procedures.

Medanta Medicity doctors in Sector 38 said the case highlights the expanding role of image-guided interventions in managing high-flow AVMs, especially during high-risk surgeries. “Such AVMs may remain silent for years but can enlarge with age, causing pain, tissue damage, functional impairment, or even life-threatening bleeding in case a vessel ruptures,” said Dr. Rajiv Parakh, chairman of Peripheral Vascular and Endovascular Sciences, Medanta Gurugram.

Parakh said in a first in India, a peripheral EVOH 6 ml embolic vial was used to treat the AVM. Scientific studies indicate that existing treatment methods, such as embolisation and surgical excision, have limited effects and are often associated with a risk of injury to vital structures, causing permanent impairment.

Notably, EVOH is an embolic agent, which offers slow, controlled delivery and deep penetration into the nidus (core) of the AVM. “Unlike earlier techniques that often required multiple sessions, the peripheral EVOH vial enabled occlusion of the AVM in a single procedure, significantly reducing complexity and recovery time,” said Dr Virender Sheorain, another vascular surgeon at the institute.

The surgery was completed in two hours. The girl, from Rohtak, Haryana,was relieved of the AVM symptoms including severe pain, swelling, skin changes and fever, further leading to near-complete occlusion of the abnormal vessels, doctors said.

“Arteriovenous malformations, especially high-flow ones in young patients, are exceptionally delicate to treat because blood rushes abnormally fast through tangled vessels. If not recognised early, they can lead to progressive tissue damage, disabling pain, or even life-threatening bleeding,” Parakh added.