A consultant interventional neuroradiologist at Leeds Teaching Hospitals has carried out a breakthrough treatment for arteriovenous malformation. 

Zehair Ayub had been living with arteriovenous malformation (AVM), a condition that causes an abnormal tangle of blood vessels in the brain, since 2011. He had exhausted all viable treatment options and his health was declining fast.

His AVM was located deep in his brain and he had developed a large aneurysm. This was pressing on his visual nerves, leaving him at high risk of potentially fatal or life-changing brain haemorrhage. He was also experiencing increasingly severe symptoms, including seizures, right-sided weakness and deteriorating vision.

The patient was offered hope after meeting with Fathallah Islim, a consultant interventional neuroradiologist at Leeds Teaching Hospitals, and hearing about a breakthrough treatment that could help him. 

“For 15 years I lived with the AVM, but I was eventually told there were no treatment options left,” the patient said. “Everything was getting worse so quickly. My eyesight was failing, my coordination was going. I knew I needed help. [The consultant] came along exactly at the right time.”

Islim had completed a fellowship at a centre in Germany that had been involved in the European trial of an innovative new therapy, called ihtObtura. The trial was not taking place in the UK, however, so Islim applied for special approval for use of ihtObtura on compassionate grounds.

Innovative treatment

The therapy, ihtObtura, is a novel liquid embolic agent that is injected into the affected blood vessels close to them to prevent blood from flowing abnormally through the AVM. It differs from other embolic agents as it is no longer visible on scans after a short period of time, and this can help to accurately guide and provide safe staged treatment of large and historically untreatable brain AVMs.

Islim and his team received support from international trial experts who travelled to Leeds General Infirmary to assist. The patient received four rounds of treatment from September last year to May this year. His AVM is now fully closed, the aneurysm is gone, and his physical symptoms have significantly improved.

“Endovascular treatment of brain AVMs is often reserved for untreatable AVMs. The risks are high and daunting for both the clinician and patient,” Islim said. “Obtura is a new, innovative material that has helped cure Zehair’s AVM and help him get his life back, which made us very happy for him and his family. We are eager to get European and UK approval for use and help patients in the near future.”