Multidisciplinary Approach Is A Way To Go For Treatment Of High Flow Head And Neck Arteriovenous Malformations

Multidisciplinary Approach in Head and Neck AVMs


  • Saima Ahmad Department of Neuroradiology, Lahore General Hospital, Lahore, Pakistan
  • Roomana Akhlaque Department of Burn and Reconstructive Surgery, Lahore General Hospital, Lahore, Pakistan
  • Moeez Uddin Manchester University NHS Foundation Trust, Manchester, United Kingdom
  • Umair Rashid Department of Neuroradiology, Lahore General Hospital, Lahore, Pakistan
  • Anchalee Churojana Department of Diagnostic Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Muhammad Aslam Khan Department of Neuroradiology, Lahore General Hospital, Lahore, Pakistan



Arteriovenous Malformation, Embolization, High Flow, Multidisciplinary, Plastic Surgery



To determine the role of the multidisciplinary approach, with the interventional radiologists and plastic surgeons working in collaboration with each other, in the management of complex high flow head and neck arteriovenous malformations to facilitate the best possible outcome.




A prospective study of seven patients with high flow head and neck AVMs treated at a tertiary care hospital between 2018 and 2020 was performed. Medical records and neuro intervention department logbook were maintained for age at first diagnosis, presenting features, prior treatments, endovascular treatment, surgical treatment, and therapeutic outcomes. A comparison between pre-procedure and post-procedure photographs was done in all cases to measure the clinical outcome.


Results: Joint ventures on seven patients with complicated high flow head and neck arteriovenous malformation were performed, there was the equivalent appropriation of men and women with an average age of coming to the hospital being 24 years. Each of the seven patients experienced embolization followed by surgical procedures inside a 24-hour window up to 72 hours. Therapeutic removal of the lesion was accomplished in six cases while palliative resection was done in the seventh case. There were minor wound healing issues in one patent which was managed through dressings.





The general findings demonstrated that embolization alone isn't successful in controlling side effects. Incomplete removal of an AVM doesn't show up to relieve symptoms either and exacerbates recurrence. The use of combined modality helps the plastic surgeon in achieving excision of high flow AVM of the head and neck. The pivotal role of the interventional radiologist in delineating the vascular anatomy and directing the surgeon towards the best possible surgical outcome helps the patient in terms of reduced intraoperative blood loss, less hemodynamic instability, reduced operating time, early recovery, and decreased hospital stay.



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How to Cite

Ahmad, S., Roomana Akhlaque, Moeez Uddin, Umair Rashid, Anchalee Churojana, & Muhammad Aslam Khan. (2022). Multidisciplinary Approach Is A Way To Go For Treatment Of High Flow Head And Neck Arteriovenous Malformations: Multidisciplinary Approach in Head and Neck AVMs. Journal Of Cardiovascular, Neurovascular &Amp; Stroke, 4(2), 1–15.