The Effectiveness of Percutaneous Transarterial Embolization for Arteriovenous Malformation

Jung, Won Sang; Hahn, Seong Tai; Lee, Sang Hoon; Hahn, Hyung Min

Abstract

PURPOSE: To determine the effectiveness of percutaneous transarterial embolization for the treatment of arteriovenous malformation (AVM).
MATERIALS AND METHODS
Seven patients with AVMs located in the kidney, liver, lung, chest wall, uterus and paraspinal region underwent angiography and percutaneous transarterial embolization. The embolic materials used were steel coil, gelfoam, contour emboli, and absolute alcohol; in some cases, more than one of these were employed. The analysed the angiographic findings and clinical status following embolization were assessed and analysed.
RESULTS
The AVMs had tortuous, dilated feeding arteries (n=7) and veins with early venous drainage (n=6). In the hepatic AVM, a grape-like dilated vessel arose from the hepatic artery and was connected to the portal vein. In the uterine AVM, numerous dilated feeding arteries formed a honeycomb. In the feeding arteries of the chest wall AVM and in the nidus of the pulmonary AVM, aneurysms were present. In simple AVMs, the patient's symptoms were relieved by first embolization. Complex AVMs, however, required repeated embolizations for symptomatic relief. Although extensive, complex AVMs of the chest wall and uterus recurred after initial embolization, repeated treatment successfully improved the clinical status of such patients. The complications developing after emboliation were fever (n=3) and pain (n=3), but these were relieved by conservative care.
CONCLUSION
Percutaneous transarterial embolization is a safe and effective therapeutic method for the treatment of AVM. In a case of inoperable complex AVM, repeated embolization is the only method for symptomatic relief and the maintenance of life.