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. 2008 Jul;41(2):183-9.
doi: 10.4103/0970-0358.44943.

Management strategy for facial arteriovenous malformations

P S Bhandari  1 , L P Sadhotra, P Bhargava, A S Bath, M K Mukherjee, Sanjay Maurya
Affiliations

Management strategy for facial arteriovenous malformations

P S Bhandari et al. Indian J Plast Surg. 2008 Jul.

Abstract

Arteriovenous malformations (AVMs) are uncommon errors of vascular morphogenesis; haemodynamically, they are high-flow lesions. Approximately 50% of AVMs are located in the craniofacial region. Subtotal excision or proximal ligation of the feeding vessel frequently results in rapid progression of the AVMs. Hence, the correct treatment consists of highly selective embolisation (super-selective) followed by complete resection 24-48 hours later. We treated 20 patients with facial arteriovenous malformation by using this method. Most of the lesions (80%) were located within the cheek and lip. There were no procedure related complications and cosmetic results were excellent.

Keywords: Arteriovenous malformation; resection; super-selective embolisation.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1A
Figure 1A
AVM involving the cheek and orbit, causing marked proptosis, chemosis, and poor vision
Figure 1B
Figure 1B
Angiogram revealed dilated anomalous vascular channels fed by internal maxillary artery, facial artery, ascending pharyngeal artery, infraorbital artery, nasal, and anterior ethmoidal arteries
Figure 1C
Figure 1C
Post embolisation angiogram using PVA particles showed a marked reduction in vascularity
Figure 1D
Figure 1D
While dissecting the facial lesion, branches of facial nerve were safeguarded
Figure 1E
Figure 1E
Postoperative result with improvement in vision
Figure 2A
Figure 2A
AVM lower lip
Figure 2B
Figure 2B
Angiogram revealed dilated anomalous vascular channels of both labial arteries
Figure 2C
Figure 2C
Angioembolization with NBCA
Figure 2D
Figure 2D
Postembolisation with NBCA
Figure 2E
Figure 2E
Local reaction with NBCA
Figure 2F
Figure 2F
Postoperative appearance
See this image and copyright information in PMC

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