Page 22 - PowerPoint Presentation
P. 22
Arteriovenous
malformation
It is typically a pulsatile high-flow lesion. USG
and arteriography is used to define anatomy
and hemodynamics whereas MRI is useful to
determine the extent of the lesion
Clinical Staging (by Schobinger)
Stage 1 (quiescent): Warm, pink to bluish
stain
Stage 2 (expansion): Thrill and dilated
venous network formation
Stage 3 (destruction): Cutaneous ulcers,
necrosis and frequent bleeding
Stage 4 (decompensation): Cardiac
decompensation
Treatment
Medical optimization of coagulopathy
secondary to thrombotic consumption
Pre-operative embolization and surgical
resection within 72 hours
Wide local excision as recurrence rate is
high
Post-excision reconstruction is often
necessary
