TREATMENT OF INTRAOSSEOUS ARTERIOVENOUS-FISTULAS OF THE EXTREMITIES

Intraosseous arteriovenous fistulas of the extremities are rare malfor mations frequently associated with severe systemic hemodynamic alterat ions. In many cases, it is quite difficult to eliminate these anomalou s vascular structures, but the possibilities for successful treatment are much greater when surgery is combined with interventional radiolog y. Selective embolization of the malformed vessels can be produced wit h a variety of agents that are injected into afferent arteries, via pe rcutaneous puncture or through direct surgical access. The intraosseou s portion of the fistula should be resected at the time of embolizatio n or later. The authors describe the successful treatment of three pat ients having intraosseous arteriovenous fistulas of the upper extremit ies, who have had follow-up for 2 to 10 years. Copyright (C) 1994 by W .B. Saunders Company