title: A new surgical technique for the treatment of life-threatening congenital arteriovenous malformation--intraluminal graft implantation.
abstract: 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.
authors.affiliation: Second Department of Surgery, Medical University, Aichi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Ohta
authors.forename: M
authors.initials: M
authors.lastname: Hosaka
authors.forename: H
authors.initials: H
authors.lastname: Ishibashi
authors.forename: I
authors.initials: I
authors.lastname: Sugimoto
authors.forename: K
authors.initials: K
authors.lastname: Hida
authors.forename: Y
authors.initials: Y
authors.lastname: Nagata
mesh_terms: 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