顔面部에 發生된 動靜脈性 畸形의 一例 및 文獻考察

Arteriovenous malformation occurring in face : a case report and review of literature

An arteriovenous malformation (AVM) may be defined as a condition in which arteries communicate with veins through channels other than the normal capillary networks. The common unifying clinical element is severe bleeding which can result from this type of lesion. Most sophisticated diagnostic studies include selective arteriogram and ultrasound flowmeter. The treatment for such mass is predicated upon a total elimination of all diseased tissue. AVM in location such as the spinal cord and cerebral vessel are particular poorly treated with surgical excision. Therefore, the technique of intraarterial embolization was first used for these lesions. Certain extensive lesions that are considered inoperable may be treated with embolization alone. The author had managed a patient, 15 year old male, with arteriovenous malformation of the left face involving mandible. Through femoral artery, embolization with polyvinyl alcohol (PVA) was performed. At 1st embolization (1983-12-30), PVA were embolized into his left facial, lingual and internal maxillary arteries. In March 1984, he had repeated gingival bleeding. An angiographic study of the carotid arteries demonstrated the AVM fed by left external carotid artery and right facial artery. At that time, PVA were embolized into his left facial, lingual arteries and right facial arteries. Sixty days postoperatively, no signs of AVM had recurred.