A new surgical technique for the treatment of life-threatening congenital arteriovenous malformation--intraluminal graft implantation.
A new surgical intraluminal graft implantation technique was undertaken in a 27-year-old man with a massive, life-threatening, high-flow congenital arteriovenous malformation (AVM) involving the left lower extremity, which was resistant to such challenges as transarterial embolizations or partial resections. For occlusion of the feeder branches, a composite graft composed of two grafts with different diameters, which matched to the arterial lumen, was surgically inserted into the superficial femoral artery. The implanted graft occluded 2 weeks after the insertion. Although amputation distal to the knee was necessary because of the foot necrosis, the graft was useful in reducing the cardiac output (from 14.3 l/min to 9.8 l/min) and obviating hip joint amputation. A further clinical study is necessary to examine whether or not it is an acceptable treatment modality.
Ohta
T
T
Second Department of Surgery, Medical University, Aichi, Japan.
Hosaka
M
M
Ishibashi
H
H
Sugimoto
I
I
Hida
K
K
Nagata
Y
Y
D000328:Adult; D000671:Amputation, Surgical; D000714:Anastomosis, Surgical / Q000295:instrumentation; D015901:Angiography, Digital Subtraction; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D008297:Male