The angiosome concept applied to arteriovenous malformations of the head and neck

Arteriovenous malformations remain a difficult clinical problem. There is v ery little understanding of the underlying pathogenesis of these lesions, a nd therapy frequently involves considerable risks with suboptimal outcomes. Recently, a comprehensive description of the angiosomes of the head and ne ck was completed in the authors' unit. It was noticed that the location of several clinically observed arteriovenous malformations in the head and nec k seemed to correspond to the anatomic location of the choke anastomotic zo nes linking the angiosomes. Therefore, selective clinical angiograms were c ompared with those from the authors' previously performed fresh cadaver inj ection studies, in which they defined the angiosomes of the head and neck. In each patient, the location of the arteriovenous malformation corresponde d directly to the choke vessel anastomotic zone linking two or more adjacen t angiosomes. Clinical and pathologic ramifications of this observation are discussed.