Intra-arterial embolization in the management of arteriovenous malformations

Eighteen patients with arteriovenous malformations (AVM's) involving the extremities, pelvis, or head are reported and their treatment is discussed. Our experience has led us to the following conclusions: (1) careful selective angiography is mandatory to delineate the vascular anatomy, extent, and major afferent vessels supplying the AVM; (2) ligation of afferent vessels to an AVM never is indicated; (3) intra-arterial embolization (IAE) can be used prior to surgical removal of extensive but resectable AVM's; (4) IAE may be employed for symptom control of inoperable AVM's.