Bilateral superior labial artery embolization for arteriovenous malformation

Area of Science:

• Vascular Surgery
• Interventional Radiology
• Plastic Surgery

Background:

• Lip arteriovenous malformations (AVMs) are congenital vascular anomalies causing significant functional and cosmetic concerns.
• Management of AVMs is complex due to varied presentations and lack of standardized treatment protocols.

Purpose of the Study:

• To present a successful case of managing an upper lip AVM using a combined embolization and surgical resection technique.
• To evaluate the efficacy and safety of using a rapidly absorbable embolic material in AVM treatment.

Main Methods:

• The case involved an upper lip AVM with bilateral facial artery and superior labial artery feeders.
• Bilateral Gelfoam embolization of feeding arteries was performed, followed by surgical resection.
• Reconstruction was achieved using a bilateral advancement flap.

Main Results:

• The patient experienced an uneventful intraoperative and postoperative course.
• No recurrence of the AVM was observed at the 1-year follow-up.
• Good functional and aesthetic results were achieved, with patient satisfaction.

Conclusions:

• A combined approach of presurgical embolization and complete surgical resection is effective for upper lip AVMs.
• Utilizing rapidly absorbable embolic material like Gelfoam minimizes complications, particularly lip necrosis, when bilateral embolization is required.