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Successful endovascular treatment of extracranial arteriovenous malformation of a head: a case report

https://doi.org/10.47093/22187332.2019.4.40-48

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Abstract

Introduction. Arteriovenous malformations (AVM) of the head represent the rare lesions that have a congenital, traumatic or post-infectious nature. In the last decade, endovascular methods have become the most prevalent in the treatment of AVM. Staged embolization is performed to achieve maximum effect and minimize the complications.

Case report. A 30-year-old female patient is presented with complaints of enlarged vessels in the frontal and parietal regions. CT-angiography scan and cerebral angiography showed extracranial AVM of the fronto-parietal regions with afferent vascular supply from the right and left superficial temporal and ophtalmic arteries with significant expansion of the afferent arteries and the presence of varix dilatation of the draining veins. Two-stage endovascular embolization of AVM was performed. The first stage was embolization of the afferent vessels from the left superficial temporal artery system with exclusion of 60–65% AVM volume. Three months later, the second stage was performed with embolization of the afferent vessels from the right superficial temporal artery system and the exclusion of 75–80% of the residual volume of AVM. The non-adhesive composition SQUIDR12 (Emboflu, Switzerland) and glue composition PHILR25% (Microvention, USA) were used. A good aesthetic effect was achieved. Postoperative complications were not observed. There was no recurrence during the observation within a year.

Summary. The staging and the use of various liquid embolization agents in the treatment of AVM of the head allow to achieve a good aesthetic outcome and prevent complications associated with facial soft tissue necrosis.

About the Authors

A. A. Sufianov
Federal Center of Neurosurgery; Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Albert A. Sufianov, doctor of medical science, professor, chief of Federal Center of Neurosurgery; head of neurosurgery department of Sechenov First Moscow State Medical University (Sechenov University)

5, 4th km Chervishevskogo tract, Tyumen, 625032
Tel.: +7 (3452) 29-37-07 



S. M. Karasev
Federal Center of Neurosurgery
Russian Federation

Sergey M. Karasev, interventional radiologist

Tyumen



R. R. Khafizov
Republican Cardiological Center
Russian Federation

Radik R. Khafizov, interventional radiologist

Ufa



R. R. Rustamov
Federal Center of Neurosurgery; Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Rakhmonzhon R. Rustamov, neurosurgeon at the Federal Center of Neurosurgery; postgraduate at the neurosurgery department, Sechenov First Moscow State Medical University (Sechenov University)

Tyumen
Moscow 



R. A. Sufianov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Rinat A. Sufianov, assistant professor at the department of neurosurgery

Moscow



E. S. Markin
Federal Center of Neurosurgery
Russian Federation

Egor S. Markin, neurosurgeon at the Federal Center of Neurosurgery

Tyumen



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ISSN 2218-7332 (Print)
ISSN 2658-3348 (Online)