Evaluation and management of congenital peripheral arteriovenous malformations

Naiem Nassiri, Nolan C. Cirillo-Penn, Jones Thomas

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

The International Society for Study of Vascular Anomalies (ISSVA) broadly categorizes vascular anomalies into vascular tumors and vascular malformations. Vascular malformations are further divided based on their flow properties into slow-flow venous and lymphatic malformations, high-flow arteriovenous malformations (AVMs), and congenital mixed syndromes, which can include combinations thereof. Whether occurring in isolation or as part of a broader syndrome, congenital high-flow AVMs are arguably the most complicated, challenging, and gratifying of all vascular malformations to diagnose and manage. Various configurations exist depending on location and coexisting clinical features. Transcatheter embolization has evolved into the mainstay of treatment for most congenital peripheral AVMs with surgical excision playing a growingly limited role as an adjunctive modality. Successful treatment requires technical precision, creativity, patience, and persistence given the ever-evolving angioarchitecture and hemodynamic profile of these lesions. Despite these challenges, certain fundamental principles have been established as our understanding of the pathogenesis, natural history, hemodynamics, and treatment outcomes has expanded and evolved over the last few decades. These principles are crucial to adhere to in the overall management of these lesions and are highlighted and expanded upon herein.

Original languageEnglish (US)
Pages (from-to)1667-1676
Number of pages10
JournalJournal of vascular surgery
Volume62
Issue number6
DOIs
StatePublished - Dec 2015
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2015 Society for Vascular Surgery.

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