Preliminary report: intratumoral ligation as a salvage procedure for the management of life-threatening arteriovenous malformations.

Arteriovenous malformations are rare, high flow vascular anomalies which are frequently difficult to manage. Treatment options include embolisation and/or surgery, the latter ranging from proximal ligation (now discredited) through to radical resection. The Popescu technique of intratumoral ligation was used to treat 3 patients with massive, life-threatening arteriovenous malformations which were considered unsuitable for embolisation therapy or surgical resection. The main complications experienced were soft tissue swelling and necrosis, transient peripheral nerve entrapment and haemorrhage. The preliminary results have been encouraging and suggest that effective palliation and control can be achieved; 1 patient has no clinically demonstrable recurrence nearly 3 years after surgery.