Voluminous arteriovenous malformation of a child's forearm treated by sequential embolizations: case report
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Updated: May 9, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Jean-Charles Aurégan1, Karen Lambot, Caroline Dana
1Department of Pediatric Orthopedics, Necker-Enfants Malades Hospital, University Paris Descartes, Sorbonne Paris Cité, Paris, France. jean-charles.auregan@abc.aphp.fr
Insights
Arteriovenous malformations (AVMs) can significantly impact bone development in infants. This case demonstrates that endovascular coil embolization alone can successfully treat forearm AVMs when surgery is not feasible.
Area of Science:
- Vascular Surgery
- Pediatric Radiology
- Interventional Radiology
Background:
- Arteriovenous malformations (AVMs) are congenital vascular anomalies characterized by abnormal direct connections between arteries and veins.
- Treatment of AVMs, particularly in pediatric cases, is often complex and necessitates a multidisciplinary approach.
- High-flow AVMs can lead to significant secondary complications, including skeletal abnormalities.
Observation:
- A 6-month-old boy presented with a large left forearm AVM.
- The AVM caused osteolysis of the radius, diaphyseal bowing, and radial head dislocation.
- Surgical excision was deemed not feasible due to the AVM's characteristics.
Findings:
- Two sequential endovascular coil embolization procedures were performed.
- These embolizations successfully controlled the AVM.
- After 3.5 years, the AVM was undetectable on imaging, with significant clinical and radiographic improvement.
Implications:
- This case highlights the profound impact of AVMs on adjacent skeletal structures in pediatric patients.
- Endovascular embolization alone can provide a satisfactory midterm outcome for complex AVMs when surgical intervention is not an option.
- This approach may offer a viable alternative for managing pediatric AVMs with significant skeletal involvement.
Abstract:
An arteriovenous malformation (AVM) is a congenital lesion with high vascular flow resulting from direct connections between arteries and veins. Its treatment is often complex, and most authors recommend a multidisciplinary approach combining surgical and endovascular treatments. We report the case of a 6-month-old boy with a voluminous AVM of the left forearm inducing osteolysis of the radius, with bowing of its diaphysis and subsequent radial head dislocation. Surgical excision of the AVM was not possible, but 2 sequential coil embolizations achieved control of the lesion. After 3.5 years, the AVM was undetectable, and notable improvement was noted both in symptoms and radiographic findings. This case underlines how an AVM can have noteworthy influence on surrounding tissues and shows that embolization alone can achieve a satisfying midterm outcome even when surgery is not possible.
