CPT® Code 61686

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 occur in the intracranial region, leading to significant clinical implications. In the case of intracranial AVMs, the direct arterial-to-venous connection results in high-pressure blood shunting into the venous system, which can lead to serious complications such as vessel rupture and hemorrhage. AVMs can be classified based on their anatomical location; those located above the tentorium cerebelli are referred to as supratentorial AVMs, while those situated below are termed infratentorial AVMs. The infratentorial region encompasses critical structures such as the cerebellum, cerebellopontine angle, fourth ventricle, and brain stem. The surgical procedure for addressing a complex infratentorial AVM involves a craniotomy, which includes creating scalp flaps, drilling burr holes, and elevating a bone flap to access the dura mater and expose the AVM. The procedure requires meticulous microsurgical techniques to identify and ligate the arterial feeders and draining veins, ultimately leading to the complete excision of the AVM. This surgical intervention is crucial for preventing potential life-threatening complications associated with AVMs.