Management of congenital arteriovenous malformations

Twenty-five patients with congenital arteriovenous malformations (AVMs) involving the head, neck, trunk, or extremities were treated over a 10-year period. In patients with more extensive lesions, selective angiography was essential to delineate the extent of the AVM and its vascular anatomy. AVMs that produced congestive heart failure, hemorrhage, pain, or cosmetic embarrassment were excised if possible. Intra-arterial embolization is useful in the reduction of vascularity before operation or as the primary treatment for unresectable lesions. Incomplete excision or embolization of the AVM often results in a recurrence. However, nonsymptomatic lesions may be observed, and extremity varicosities can be treated by external compression.