Case#14

History: Young female with enlargement in the calf and significant pain limiting her activities. No skin abnormalities. 

Work-up: MRI was performed which suggested an AVM lesion (high-flow vascular birthmark) in the calf. A decision was then made to further investigate with conventional arteriogram (angiography) with possible intervention. Several embolizations had been performed using particles and coils for venous embolization. Due to some residual discomfort, arteriogram with embolization was repeated.

Procedure / Discussion: 1st angiographic image shows a residual AVM nidus below the knee. 2nd and 3rd angiographic images are selective contrast injections in the small arterial feeders demonstrating AV connections (early venous opacification is obvious). The AVM nidus was then embolized with particles - embospheres using a microcatheter system. Follow-up arteriogram shows no significant residual abnormal AV connection and patent runoff arteries. For further information on transcatheter embolization click here.

Diagnosis: AVM