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P-027 The Role of Interventional Therapy in Head and Neck Arteriovenous Malformations
  1. A Dmytriw,
  2. K terBrugge,
  3. T Krings,
  4. R Agid
  1. Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada


Introduction Head and neck arteriovenous malformations (H&N AVM) are challenging to treat, and impart clinical and psychosocial morbidity. We evaluated the role of endovascular therapy and its success with varying presentations and characteristics.

Methods Our retrospective period spanned 1984 to 2013, and included any patients who received neurointerventional treatment. Candidate AVMs involved the scalp, orbit, maxillofacial, and upper neck. All available clinical, surgical, interventional and imaging records were reviewed.

Results 89 patients with H&N AVMs received endovascular therapy, including 48 small and 41 large lesions. The goals of treatment were identified as curative (n = 30), palliative (n = 34), or presurgical (n = 25). The average number of treatment sessions per patient was 1.5. The goal of treatment was met in 92.1% of cases, and cure was achieved in 42 patients accounting for 58.4% of the total patients for all categories. 28 patients were cured by embolization alone (31.4%) of which 18 were single-hole AVFs. 24 received presurgical embolization (27%) and were cured by subsequent excision. 30 patients reported adequate palliation of their complaints (33.7%). 7 patients suffered transient and 2 permanent endovascular treatment complications.

Conclusion Interventional treatment can be curative, particularly in small AVMs, with surgical excision as an important option. However, the role of endovascular therapy should not be underestimated in terms of palliation of large lesions, including complex incurable lesions.

Disclosures A. Dmytriw: None. K. terBrugge: None. T. Krings: None. R. Agid: None.

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