Sarah-Jayne Campbell, Helen Witherow, Lino Locurcio
Arteriovenous malformations are congenital, potentially life-threatening, vascular defects, in which arteries and veins are directly associated, without an intervening capillary bed between them. It has been reported that after haemorrhage there is a significant risk of serious morbidity and mortality. Taking this into account particularly for those AVM’s which are inoperable; appropriate conservative management to prevent wound breakdown and further haemorrhage, has the potential to reduce morbidity and extend life expectancy in these patients. Guidelines for treatment of AVM’s are currently not very well established in the literature. For those considered to be inoperable, partial embolisation is suggested, however it has been recognised that the technique has significant downfalls and can in fact worsen the natural history. We report a conservative management strategy that we have developed for the management of this condition and present the case of a 46 year old male who had regular episodes of haemorrhaging from his extensive AVM in which our strategy was successfully implemented.