直接穿刺及び経静脈的血管塞栓術が奏効した 大腿及び骨盤type-II AVMの2例

抄録

We report two cases of symptomatic arteriovenous malformations (AVMs) with dominant outflow veins (DOV), categorized as type-II AVM, according to the Cho classification. The first case was a large posterior thigh AVM involving the hamstring, mainly biceps femoris muscle. In the prone position, several DOVs were embolized by direct needle puncture using pushable fibered coils in combination with n-butyl cyanoacrylate or ethanol. After two sessions, angiography revealed disappearance of the AVM. The second case was an AVM in the left pelvic cavity. The DOV was embolized retrogradely by transvenous approach using detachable coils and ethanol. AV shunting was significantly reduced, and pain relief was obtained shortly after wards. We consider that symptomatic type-II AVM of the extremity and trunk can be successfully treated by appropriate anatomical assessment, embolization approach and choice of embolic agents.