Congenital arteriovenous malformations. The role of transcatheter arterial embolization
A. S. Gomes, R. W. Busuttil, J. D. Baker, W. Oppenheim, H. I. Machleder and W. S. Moore
We treated 11 patients with congenital arteriovenous malformations (AVMs)
with staged transcatheter arterial embolization of their lesions. In nine
patients, the AVM involved an extremity. One patient had multiple pulmonary
AVMs, another an AVM of the pancreas. Embolization was performed using
polyvinyl alcohol sponge (Ivalon) particles and Gianturco-Wallace colls.
Nine patients had a systemic response to embolization, characterized by
pain, fever, leukocytosis, and elevated enzyme levels. Complications (three
major, two minor) developed in five patients. A total of 28 staged
embolizations were performed, with follow-up to 36 months. We found
transcatheter embolization a useful palliative therapy in treating
congenital AVMs. It should be considered as a therapeutic alternative for
patients with unresectable AVMs, those for whom amputation would be
required, and those who are otherwise poor surgical candidates.
