Congenital arteriovenous anomalies of the limbs

Observations in 33 patients with congenital arteriovenous fistulas described ten years ago have been extended with the addition of 49 other cases; the clinical, pathologic, and roentgenographic characteristics of these lesions in the entire group of 82 patients have been summarized. The findings in the entire group over the additional observation period have confirmed the conclusions previously reached, namely, that (1) these clinically extremely varied lesions have a unitary (developmental) cause; (2) for rational management, angiographic investigation is indispensable to establish their extent and complexity; (3) with few exceptions, their radical cure by surgical means is impossible; and (4) the large majority of patients do well on a carefully supervised conservative regimen, with surgical intervention reserved for individually defined instances.