ABSTRACT
Arteriovenous malformation (AVM) is much different from the rest of the congenital vascular malformations (CVMs) in its clinical behavior due to its unique anatomic defect involving the vessels of both arterial and venous origins, resulting in direct communications to allow the shunting of arterial blood to the venous system. Such hemodynamic complexity involving the arterial, venous, and lymphatic systems with altered cardiovascular hemodynamics, centrally, peripherally, and locally, makes the lesion a potentially limb- if not life-threatening condition. Hence, the AVM is “the most dangerous” primitive CVM with high recurrence risks that cause serious consequences so that ideally an early aggressive approach is favored for all AVM lesions to reduce the consequence of its hemodynamic impact by delayed treatment. However, the currently available treatments for AVM in general carry significant risk for complications and morbidity. The decision for treatment as well as selection of the treatment modalities should be made using a multidisciplinary team approach based on the proper indications and should proceed only when the benefit exceeds the associated morbidity of the proposed treatment to achieve effective control of AVM lesions.
