A NEW SURGICAL TECHNIQUE FOR THE TREATMENT OF LIFE-THREATENING CONGENITAL ARTERIOVENOUS MALFORMATION - INTRALUMINAL GRAFT IMPLANTATION

A new surgical intraluminal graft implantation technique were undertak en in a 27-year-old man with a massive, life-threatening, high-flow co ngenital arteriovenous malformation (AVM) involving the left lower ext remity, which was resistant to such challenges as transarterial emboli zations or partial resections. For occlusion of the feeder branches, a composite graft composed of two grafts with different diameters, whic h matched to the arterial lumen, was surgically inserted into the supe rficial femoral artery. The implanted graft occluded 2 weeks after the insertion. Although amputation distal to the knee was necessary becau se of the foot necrosis, the graft was useful in reducing the cardiac output (from 14.3 l/min to 9.8 l/min) and obviating hip joint amputati on. A further clinical study is necessary to examine whether or not it is an acceptable treatment modality.