Radiology, Vol 144, 41-49, Copyright © 1982 by Radiological Society of North America
Embolization therapy in the management of congenital arteriovenous malformations
AS Gomes, WP Mali and WL Oppenheim
Eight patients with congenital arteriovenous malformations (AVMs) underwent
staged transcatheter arterial embolization. Six patients had AVMs involving
an extremity, one had multiple pulmonary AVMs, and one had an AVM of the
pancreas. Embolization was performed using Ivalon (polyvinyl alcohol)
particles and Gianturco coils. Clinical course, fever pattern, and
appropriate enzymatic laboratory studies were monitored. Leukocytosis
occurred in all but one patient following embolization. A febrile course
with the temperature reaching 39.6 degrees C without evidence of infection
was seen in several patients for 3 to 5 days postembolization. Marked
elevation in the creatine phosphokinase level and positive fibrin split
products were noted in several instances. Because embolizations were
performed in stages, serial arteriography was available. Embolization
resulted in a reduction in symptoms in all eight patients and allowed a
more limited surgical procedure than would otherwise have been possible in
two patients. Complications occurred in three patients and are described.
It is concluded that transcatheter arterial embolization is a useful
therapeutic alternative in the management of congenital AVMs.
