Transcatheter embolization in the management of congenital arteriovenous malformations

Congenital arteriovenous malformations (AVMs) with multiple arterial feeders in eight patients were managed by transcatheter embolization, with a combination of polyvinyl alcohol foam (Ivalon), detachable silicone balloons, and wool coils. Due to the extensive number of arterial feeders often present, multiple procedures with several days in between were frequently necessary. When possible, surgical resection after embolization is the procedure of choice. Inoperable AVMs are best managed by segmental distal embolization of all arterial feeders with a permanent occluding material. Embolization therapy as a primary form of management is considered palliative and temporary relief of symptoms is usually achieved.