CPT® Code 61680

An arteriovenous malformation (AVM) is a pathological condition characterized by an abnormal connection between the arterial and venous systems, where one or more arteries and veins connect directly without the intermediary of capillaries. This congenital malformation can lead to significant complications due to the high-pressure shunting of blood into the venous system, which may result in vessel rupture and subsequent hemorrhage. Specifically, intracranial AVMs are located within the skull and can be classified based on their anatomical position relative to the tentorium cerebelli, a membrane that separates the cerebrum from the cerebellum. A supratentorial AVM is situated above this membrane and encompasses critical structures such as the cerebral hemispheres, lateral and third ventricles, choroid plexus, hypothalamus, and the pineal and pituitary glands. In contrast, infratentorial AVMs are found below the tentorium and involve the cerebellum, cerebellopontine angle, fourth ventricle, and brain stem. The surgical procedure for addressing a supratentorial AVM involves a craniotomy, which entails creating scalp flaps, drilling burr holes, and elevating a bone flap to access the dura mater and expose the AVM. The procedure employs microsurgical techniques to meticulously locate and ligate the arterial feeders and draining veins, ultimately excising the AVM. This surgical intervention is critical for preventing the potential life-threatening consequences associated with AVMs, such as hemorrhagic stroke.