Ramírez-Senent Belén, Abadal José M, Vázquez Esther, Lago Isabel, Gálvez Esther, Araujo Miguel A, de la Quintana Manuel I
1 Gregorio Marañon University Hospital, Madrid, Spain.
2 Hospital Universitario Severo Ochoa, Leganes, Madrid, Spain.
Vasc Endovascular Surg. 2017 Nov;51(8):572-576. doi: 10.1177/1538574417731206. Epub 2017 Sep 27.
High-flow arteriovenous malformations (AVMs) may pose a challenge for endovascular treatment due to high-flow rates. Incomplete treatment, recurrence, or even worsening can occur if a proper management is not performed. We report a case successfully treated with endovascular therapy.
A 37-year-old male was referred to our hospital with a soft tumor in the left thigh, limb asymmetry and associated pain. Doppler ultrasound and magnetic resonance imaging showed an extensive high-flow AVM with a venous aneurysm of 40 mm diameter. Diagnostic angiography identified multiple feeding vessels from the profunda femoris and superficial femoral arteries. Two endovascular interventions were performed within 1 month, combining afferent vessel embolization and percutaneous thrombin injection into the nidus, to exclude the AVM. Two-year imaging follow-up revealed thrombosis of the malformation. The patient remained asymptomatic with normal thigh diameter. No complications were documented in any of the sessions.
Endovascular therapy could be a safe and effective option for AVM as long as it includes not only feeding vessels embolization but also complete occlusion of the nidus.
