DIRECT PUNCTURE OF LARGE ARTERIOVENOUS-MALFORMATIONS IN HEAD AND NECKFOR EMBOLIZATION AND SUBSEQUENT RECONSTRUCTIVE SURGERY

Five patients with large arteriovenous malformations (AVM) of the head and neck, which were too large or inconveniently placed for operation alone, were treated by embolisation after direct puncture; two of the m were subsequently operated upon. They all recovered without complica tions. Embolisation of the nidus and subsequent operation is a good al ternative for the treatment of large AVM. Ligating the supplying arter ies is not a treatment. If the arterial routes to the nidus have previ ously been closed by ligatures selective catheterisation is impossible , though direct puncture of the nidus is a possibility. The nidus of t he AVM can then be obliterated by embolisation either as a treatment, or as a preoperative procedure.