Cervical Congenital Arteriovenous Malformation

Congenital cervical arteriovenous malformations are unusual lesions. Definitive diagnosis and assessment of the extent of the lesion is best obtained by four vessel cervicothoracic aortography with selective arteriography, rapid phase radiography and subtraction techniques. The futility and even deleterious effects of elective arterial ligation have been repeatedly documented in the literature. It is our opinion that arterial ligation should be limited to control of life threatening hemorrhage or as part of definitive resection. In an attempt to minimize operative hemorrhage, we have successfully utilized the technique of preoperative transcutaneous selective embolization in preparation for total surgical excision. We recommend this technique as an effective means of minimizing operative hemorrhage.