Arteriovenous Malformations of the Upper Limb

  • S. Sulaiman Shoab
  • J. H. Scurr

Abstract

The term arteriovenous malformations (AVMs) usually refers to congenital defects. About 10% of these malformations involve the upper extremities. AVMs are pathologically a diverse group of lesions. They are, in general, much more difficult to cure than the acquired arteriovenous fistulas (AVFs). This has led to less than appropriate management in many instances. Clinically, AVMs of the limbs are taken to include simple and cavernous hemangiomas, microarteriovenous and macroarteriovenous fistulas, venous angiomas, and mixed congenital vascular malformations (Figure 99.1). They range in size from tiny glomus tumors to massive AVFs.2 New growths of the vascular elements, on the other hand, are acquired lesions. These are identifiable by their cellular or gross appearance. They are not AVMs, by definition. Experience with AVMs is limited to specialized centers, and many studies referred to are case reports.

Keywords

Ischemia Radionuclide Sarcoma Expense Sponge 

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References

  1. 1.
    Riles TS, Rosen RJ. Arteriovenous malformations. In: Strandness E, Breda AV, eds. Vascular Diseases. New York: Churchill Livingstone; 1994:1115–1120.Google Scholar
  2. 2.
    McClinton MA. Tumors and aneurysms of the upper extremity. Hand Clin. 1993;9:151–169.PubMedGoogle Scholar
  3. 3.
    Servelle M. Agenesis d’une des veines principales du membre inferieur. Coeur Med Interne. 1965:4:53.Google Scholar
  4. 4.
    Folkman J, D’Amora P. Blood vessel formation: what is its molecular basis? Cell. 1996;87:1153–1155.PubMedCrossRefGoogle Scholar
  5. 5.
    Szilagyi S, Elliot JP, DeRusso FJ, Smith RF. Peripheral congenital arteriovenous fistulas. Surgery. 1965;57:61–81.PubMedGoogle Scholar
  6. 6.
    Belov S. Haemodynamic pathogenesis of vascular-bone syndromes in congenital vascular defects. Int Angiol. 1990;9:155–161.PubMedGoogle Scholar
  7. 7.
    Nakada K, Kawada T, Fujioka T, et al. Hemangioma of the upper arm associated with massive hemorrhage in a neonate. Surg Today. 1993;23:273–276.PubMedCrossRefGoogle Scholar
  8. 8.
    Nakamura K. Multiple glomus tumors associated with arteriovenous fistulas and with nodular lesions of the finger joints. Plast Reconstr Surg. 1992;90:675–683.PubMedCrossRefGoogle Scholar
  9. 9.
    Kromhout JG, v d’Horst C, Peeters F, Gerhard M AD. The combined treatment of congenital vascular defects. Int Angiol. 1990;9:203–207.PubMedGoogle Scholar
  10. 10.
    Witt JD, Jupiter JB. Kaposi’s sarcoma in the hand seen as an arteriovenous malformation. J Hand Surg [Am]. 1991;16:607–609.CrossRefGoogle Scholar
  11. 11.
    Elliott JA, Rankin RN, Inwood MJ, Milne JK. An arteriovenous malformation in pregnancy: a case report and review of the literature. Am J Obstet Gynecol. 1985;152:85–88.PubMedGoogle Scholar
  12. 12.
    Regan PJ, Roberts JO, Bailey BN. Acute posterior interosseous nerve palsy caused by bleeding from an arteriovenous malformation. J Hand Surg [Am]. 1991;16:272–273.CrossRefGoogle Scholar
  13. 13.
    Mullikan JB. Classification of vascular birthmarks. In: Grainger RG, Allison DJ, eds. Vascular Birthmarks, Haemangiomas, and Malformations. Philadelphia, Pa: WB Saunders; 1988:24–37.Google Scholar
  14. 14.
    Cohen JM, Weinreb JC, Redman HC. Magnetic resonance imaging of a congenital arteriovenous malformation of the forearm. Surgery. 1986;99:623–625.PubMedGoogle Scholar
  15. 15.
    Pearce WH, Rutherford RB, Whitehill TA, Davis K. Nuclear magnetic resonance imaging: its diagnostic value in patients with congenital vascular malformations of the limbs. J Vasc Surg. 1988;8:64–70.PubMedGoogle Scholar
  16. 16.
    Weiss KL, Beltran J, Lubbers LM. High-field MRI surface-coil imaging of the hand and wrist, II: pathologic correlations and clinical relevance. Radiology. 1986;160:147–152.PubMedGoogle Scholar
  17. 17.
    Bergqvist D, Bornmyr S. New aspects on thermography as a non-invasive diagnostic method for arterio-venous anastomoses in the extremities. Vasa. 1986;15:241–244.PubMedGoogle Scholar
  18. 18.
    Cabbabe EB. Xeroradiography as an aid in planning resection of arteriovenous malformation of the upper extremities. J Hand Surg [Am]. 1985;10:670–674.Google Scholar
  19. 19.
    Kromhout JG, v d’Horst C, Peeters F, Gerhard M. The combined treatment of congenital vascular defects. Int Angiol. 1990;9:203–207.PubMedGoogle Scholar
  20. 20.
    Allen PW, Enzinger PM. Haemangiomas of skeletal muscle. An analysis of 80 cases. Cancer. 1972;29:8–22.PubMedCrossRefGoogle Scholar
  21. 21.
    Moye SJ, Billmire DA. Congenital arteriovenous malformation of the finger resulting in cardiac decompensation: a case report. J Hand Surg [Am]. 1992;17:887–891.CrossRefGoogle Scholar
  22. 22.
    Szilagyi DE, Smith RF, Elliot JP, Hageman JH. Congenital arteriovenous anomalies of the limbs. Arch Surg. 1976;111:423–429.PubMedCrossRefGoogle Scholar
  23. 23.
    Ernst CB, Reddy DJ. Surgical treatment of acquired and congenital arteriovenous fistulae. In: Jamieson CW, Yao JT, eds. Vascular Surgery. 5th ed. London: Chapman & Hall Medical; 1995:426–433.Google Scholar
  24. 24.
    Yakes W, Luethke JM, Merland JJ, et al. Ethanol embolization of arteriovenous fistulas: a primary mode of therapy. J Vasc Interv Radiol. 1990;1:89–96.PubMedCrossRefGoogle Scholar
  25. 25.
    Jackson JE, Allison DJ. Combined therapeutic embolization and surgery. In: Jamieson CW, Yao JT, eds. Vascular Surgery. 5th ed. London: Chapman & Hall Medical; 1995:435–450.Google Scholar
  26. 26.
    Stolzel U, Schiffter R, Sorensen R, et al. Sympathektomie bei Kausalgieschmerz durch arteriovenose Malformationen der oberen extremitat. Med Klin. 1988;3:470–472.Google Scholar
  27. 27.
    Vaughan M, Henessey O, Jamieson C, Hemingway AP, Allison DJ. The preoperative embolization of vascular malformations. Br J Radiol. 1985;58:717–720.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • S. Sulaiman Shoab
  • J. H. Scurr

There are no affiliations available

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