Pa. Svendsen et al., DIRECT PUNCTURE OF LARGE ARTERIOVENOUS-MALFORMATIONS IN HEAD AND NECKFOR EMBOLIZATION AND SUBSEQUENT RECONSTRUCTIVE SURGERY, Scandinavian journal of plastic and reconstructive surgery and hand surgery, 28(2), 1994, pp. 131-135
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.