A man from Bradford has become the first patient in the UK to undergo a pioneering new treatment for a life-threatening brain arteriovenous malformation (AVM), offering fresh hope to patients with previously untreatable conditions.
After living with the condition for 15 years and exhausting all available treatment options, Zehair Ayub underwent a series of groundbreaking procedures at Leeds General Infirmary that have successfully closed his AVM and eliminated a dangerous aneurysm that had placed him at significant risk of a catastrophic brain haemorrhage.
AVMs are rare abnormalities in which arteries and veins connect directly, creating a tangled network of blood vessels. These malformations disrupt normal blood flow and can result in life-threatening bleeding if they rupture.
For Zehair, the condition was particularly complex. Located deep within his brain, the AVM had also developed a large aneurysm that was compressing his optic nerves, causing progressive vision loss and increasing the risk of a potentially fatal bleed.
Zehair was first diagnosed in 2011 and initially underwent Gamma Knife treatment in Sheffield. However, the procedure failed to resolve the AVM. Over the following years, he explored several other treatment options, but none offered a realistic chance of success. Due to the AVM's difficult location, traditional surgery was considered too dangerous.
As his symptoms worsened, Zehair experienced seizures, weakness on his right side and continued deterioration of his eyesight, all while living with the knowledge that a major brain haemorrhage could occur without warning.
A breakthrough came when Leeds Teaching Hospitals Consultant Interventional Neuroradiologist Dr Fathallah Islim secured special approval for Zehair to receive a novel treatment known as ihtObtura on compassionate grounds. The innovative therapy was being evaluated as part of a European clinical trial that was not available in the UK.
The treatment uses a specialised liquid embolic agent that is injected directly into abnormal blood vessels, sealing them and preventing blood from flowing through the AVM. Unlike conventional embolic materials, ihtObtura gradually becomes invisible on imaging scans, allowing clinicians to visualise surrounding blood vessels more clearly and plan additional treatment stages with greater accuracy.
This development is particularly significant for patients with large and complex AVMs, many of whom have historically been considered untreatable.
Supported by leading specialists from Germany and Spain, who travelled to Leeds to assist the clinical team, Zehair underwent four treatment sessions between September 2025 and May 2026.
The outcome has been transformative. His AVM has been completely closed, the aneurysm has resolved and many of his neurological symptoms have significantly improved.
Zehair Ayub said:
“When I was diagnosed, I was fit and healthy. I played football and cricket, went to the gym and was always active. Then almost overnight, everything changed. I’d gone from never having heard of an AVM before to being told I had this rare condition and that it could cause a catastrophic bleed. I had a young family and my own business. I just wanted to get back to normal and carry on with my life.
“For 15 years I lived with the AVM, but I was eventually told there were no treatment options left. Everything was getting worse so quickly. My eyesight was failing, my coordination was going, I knew I needed help. Dr Fathallah came along at exactly the right time.
“I knew I was taking a chance on a new treatment, but I had complete confidence in the team. Having experts from Leeds working alongside colleagues from Germany and Spain gave me real reassurance that I was in the best possible hands.”
Dr Fathallah Islim said:
“Endovascular treatment of brain AVMs is often reserved for untreatable AVMs. The risks are high and daunting for both the clinician and patient. 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 other patients in the near future.”
The case highlights the growing role of international collaboration, clinical innovation and advanced neurointerventional techniques in tackling some of the most challenging vascular conditions treated within the NHS. It also positions Leeds as an emerging centre for cutting-edge treatment of complex brain AVMs.
Image credit: iStock
