Surgical resection of high-flow arteriovenous malformation of the nasogenian sulcus with preoperatory embolization. A case report

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Lara Fernández R.
Paul Boettiger B.
Héctor Bahamonde S.

Keywords

Arteriovenous malformation (AVM), high-flow, superselective embolization

Abstract

The 50% of arteriovenous malformations (AVMs) of high flow are located in the craniofacial region and can cause life-threatening bleeding without a diagnosis and appropriate treatment. Magnetic resonance imaging is useful in the differential diagnosis of vascular lesions, being the gold standard selective angiography. Since high-flow AVMs do not regress spontaneously, treatment usually involves surgical resection with subsequent embolization. We present a 20years male patient consulting with a purple, progressive, soft, pulsating enlargement of right-side nasogenian region. Magnetic resonance imaging shows serpiginous vessels, extending from the subcutaneous to the anterior wall of the maxillary. Cerebral angiography confirms high flow AVM and shows vascular mapping. It was decided superselective preoperative embolization with subsequent tumor by transvestibular access.

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