Peripheral High-Flow AVM Treatment Approach

Case Presentation: Peripheral high flow AVM how to approach.

Background: A young female patient, with known history of recurrent right knee swelling and severe pain, a Doppler revealed arteriovenous malformation, underwent previous session of embolization.

Material and Methods: Through a right antegrade transfemoral approach under local anesthesia. Selective catheterization of the right popliteal artery was done using 5F Bern catheter. Angiography revealed the AVM architecture at the right knee with multiple tiny feeders. Super selective catheterization of the three feeders via microcatheter Headway over traxcess was done till reaching just proximal to the nidus. embolization was done using Glubran-Lipidol embolic mixture.

Results: Control angiography revealed occlusion of approximately 85% of the nidus with patent tibial arch.

Conclusion: Based on the angiographic classification of AVMs the treatment strategies should vary. The typical treatment approach and embolotherapy should be based on the angiographic types of AVMs. For high flow peripheral AVM it is better to first reduce the blood flow velocity in the AVM with coils, then preform embolotherapy of the residual shunts.

Publication History

Article published online:
02 April 2024