Therapeutic embolization of facial arteriovenous fistulae

Two cases of percutaneous transfemoral embolization of facial hemangiomas and arteriovenous (AV) malformations are reported. In both cases, Ivalon shavings were injected through a percutaneously placed catheter to permanently occlude peripheral feeders of the AV malformation. In one case, because of the size of the large venous sacs associated with the malformation, a steel coil was introduced to form a baffle, over which several additional strands of surgical silk were introduced to obliterate these sacs. These cases emphasize the need for embolization of small feeding arteries to prevent recurrence by collateral channels. To achieve this, specific-sized emboli are necessary; Ivalon is a suitable embolic material.