Endovascular Treatment of AVMs: Head and Neck

  • Wayne F. Yakes
  • Krasnodar Ivancev
  • Robert L. Vogelzang
  • Alexis M. Yakes


Vascular anomalies constitute some of the most difficult diagnostic and therapeutic enigmas that can be encountered in the practice of medicine, particularly in the complex anatomy of the head and neck region. Daunting functional anatomy and gross disfigurement are significant issues in the management of such anomalies in the head and neck area. Clinical presentations can be extremely varied, and attributing these symptoms that a patient may present with to a vascular malformation can be challenging to the most experienced physician. In the head and neck anatomy, the diagnosis can be somewhat easier as opposed to diagnoses in other areas of the body.


  1. 1.
    Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;69:415.CrossRefGoogle Scholar
  2. 2.
    Mulliken JB, Zetter BR, Folkman J. In vitro characteristics of endothelium from hemangiomas in vascular malformations. Surgery. 1982;92:348.PubMedGoogle Scholar
  3. 3.
    Glowacki J, Mulliken JB. Mast cells in hemangiomas and vascular malformations. Pediatrics. 1982;70:48.PubMedGoogle Scholar
  4. 4.
    Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg. 1983;18:894.CrossRefPubMedGoogle Scholar
  5. 5.
    Yakes WF, Haus DK, Parker SH, Gibson MD, Hopper KD, Mulligan JS, Pevsner PH, Johns JC Jr, Carter TE. Symptomatic vascular malformations: ethanol embolotherapy. Radiology. 1989;170:1059–66.CrossRefPubMedGoogle Scholar
  6. 6.
    Sorimachi T, Koike T, Takeuchi T, Minakawa T, Abe H, Nishimaki K, Ito Y, Tanaka R. Embolization of cerebral AVMs achieved with PVA particles: angiographic reappearance and complications. AJNR Am J Neuroradiol. 1999;20:1323–8.PubMedGoogle Scholar
  7. 7.
    White RI Jr, Pollack J, Persing J, Henderson KJ, Thompson JG, Burdge CM. Long-term outcome of embolotherapy and surgery for high-flow extremity AVMs. J Vasc Interv Radiol. 2000;11:1285–95.CrossRefPubMedGoogle Scholar
  8. 8.
    Rao VR, Mandalam KR, Gupta AK, Kumar S, Joseph S. Dissolution of isobutyl-2-cynaoacrylate on long-term follow-up. AJNR Am J Neuroradiol. 1989;10:135–41.PubMedGoogle Scholar
  9. 9.
    Dickey KW, Pollack JS, Meier GH, Denny DF, White RI Jr. Management of large high-flow AVMs of the shoulder and upper extremity with transcatheter embolotherapy. J Vasc Interv Radiol. 1995;6:765–73.CrossRefPubMedGoogle Scholar
  10. 10.
    Rosen RJ, Contractor S. The use of cyanoacrylate adhesives in the management of congenital vascular malformations. Semin Interv Radiol. 2004;21:59–66.CrossRefGoogle Scholar
  11. 11.
    Jahan R, Murayama Y, Gobin YP, Duckwiler GR, Vinters HV, Vinuela F. Embolizations with onyx clinicopathological experience in 23 patients. Neurosurgery. 2001;48:984–95.PubMedGoogle Scholar
  12. 12.
    Bruno CA Jr, Meyers PM. Endovascular management of AVMs of the brain. Interv Neurol. 2013;1:109–23.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Rak KM, Yakes WF, Ray RL, et al. MR imaging of peripheral vascular malformations. AJR Am J Roentgenol. 1992;159:107–12.CrossRefPubMedGoogle Scholar
  14. 14.
    Yakes WF. Endovascular management of high-flow arteriovenous malformations. Semin Interv Radiol. 2004;21:49–58.CrossRefGoogle Scholar
  15. 15.
    Vogelzang RL, Yakes WF. Vascular malformations: effective treatment with absolute ethanol. In: Pearce WH, Yao JST, editors. Arterial surgery: management of challenging problems. Stanmford: Appleton and Lange publishers; 1997. p. 553–60.Google Scholar
  16. 16.
    Yakes WF, Krauth L, Ecklund J, Swengle R, Dreisbach JN, Seibert CE, Baker R, Miller M, VanderArk G, Fullagar T, Prenger E. Ethanol endovascular management of brain arteriovenous malformations: initial results. Neurosurgery. 1997;40:1145–54.CrossRefPubMedGoogle Scholar
  17. 17.
    Yakes WF, Luethke JM, Parker SH, Stavros AT, Rak KM, Hopper KD, Dreisbach JN, Griffin DJ, Seibert CE, Carter TE, Guilliland JD. Ethanol embolization of vascular malformations. Radiographics. 1990;10:787–96.CrossRefPubMedGoogle Scholar
  18. 18.
    Yakes WF, Pevsner PH, Reed MD, Donohue HJ, Ghaed N. Serial embolizations of an extremity arteriovenous malformation with alcohol via direct percutaneous puncture. AJR Am J Roentgenol. 1986;146:1038–40.CrossRefPubMedGoogle Scholar
  19. 19.
    Kerber C. Balloon catheter with a calibrated leak: a new system for superselective angiography and occlusive catheter therapy. Radiology. 1976;120:547–50.CrossRefPubMedGoogle Scholar
  20. 20.
    Yakes WF, Parker SH, Gibson MD, Haas DK, Pevsner PH, Carter TE. Alcohol embolotherapy of vascular malformations. Semin Interv Radiol. 1989;6:146–61.CrossRefGoogle Scholar
  21. 21.
    Park KB, Do YS, Kim DI, Kim YK, Shin BS, Park HS, et al. Predictive factors for response of peripheral arteriovenous malformations to embolization therapy: analysis of clinical data and imaging findings. J Vasc Interv Radiol. 2012;23:1478–86.CrossRefPubMedGoogle Scholar
  22. 22.
    Keljo DJ, Yakes WF, Andersen JM, Timmons CF. Recognition and treatment of venous malformations of the rectum. J Pediatr Gastroenterol Nutr. 1996;23:442–6.CrossRefPubMedGoogle Scholar
  23. 23.
    Do YS, Yakes WF, Shin SW, Lee BB, Kim DI, Liu WC, Shin ES, Kim DK, Choo SW, Choo LW. Ethanol embolization of arteriovenous malformations: interim results. Radiology. 2005;235:674–82.CrossRefPubMedGoogle Scholar
  24. 24.
    WFJ Y. Endovascular management of high flow arteriovenous malformations. Chin J Stomatol. 2008;43:327–32.Google Scholar
  25. 25.
    Vinson AM, Rohrer DB, Wilcox CW, et al. Absolute ethanol embolization for peripheral arteriovenous malformation: report of 2 cures. South Med. 1988;381:1052–5.CrossRefGoogle Scholar
  26. 26.
    Yakes WF, Haas DK, Parker SH, Gibson MD, Hopper KD, Mulligan JS, Pevsner PH, Johns JC, Carter TE. Symptomatic vascular ethanol embolotherapy. (RSNA – SCVIR special series I). Radiology. 1989;170:1059–66.CrossRefPubMedGoogle Scholar
  27. 27.
    Mourao GS, Hodes JE, Gobin YP, Casasco A, Aymard A, Merland JJ. Curative treatment of scalp arteriovenous fistulas by direct puncture and embolization with absolute alcohol. J Neurosurg. 1991;75:634–7.CrossRefPubMedGoogle Scholar
  28. 28.
    Yakes WF, Rossi P, Odink H. Arteriovenous malformation management: how I do it. Cardiovasc Intervent Radiol. 1996;19:65–71.CrossRefPubMedGoogle Scholar
  29. 29.
    Yakes W, Baumgartner I. Interventional treatment of arterio-venous malformations. Gefasschirurgie. 2014;19:325–30.CrossRefGoogle Scholar
  30. 30.
    Yakes WF, Luethke JM, Merland JJ, Rak KM, Slater DD, Hollis HW, et al. Ethanol embolization of arteriovenous fistulas: a primary mode of therapy. J Vasc Interv Radiol. 1990;1:89–96.Google Scholar
  31. 31.
    Cho SK, Do YS, Kim DI, Kim YW, Shin SW, Park KB, Ko JS, Lee AR, Choo SW, Choo IW. Peripheral arteriovenous malformations with a dominant outflow vein: results of ethanol embolization. Korean J Radiol. 2008;9:258–67.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Yakes WF. Extremity venous malformations: diagnosis and management. Semin Interv Radiol. 1994;11:332–9.CrossRefGoogle Scholar
  33. 33.
    Yakes WF. Diagnosis and management of venous malformations. In: Savader SJ, Trerotola SO, editors. Venous interventional radiology with clinical perspectives. New York: Thieme Medical Publishers Inc; 1996. p. 139–50.Google Scholar
  34. 34.
    Levardi AM, Mangiri M, Vaghi M, Cazzulari A, Carrafiello G, Mattassi R. Sclerotherapy of peripheral venous malformations: a new technique to prevent serious complications. Vasc Endovasc Surg. 2010;44:282–8.CrossRefGoogle Scholar
  35. 35.
    Bisdorff A, Mazighi M, Saint-Maurice JP, Chapot R, Lukaszuricz AC, Houdart E. Ethanol threshold doses for systemic complications during sclerotherapy of superficial venous malformations: a retrospective study. Neuroradiology. 2011;53:891–4.CrossRefPubMedGoogle Scholar
  36. 36.
    Hyun D, Do YS, Park KB, Kim DI, Kim YW, Park HS, Shin SW, Song YG. Ethanol embolotherapy of foot AVMs. J Vasc Surg. 2013;58:1619–26.CrossRefPubMedGoogle Scholar
  37. 37.
    Park HS, Do YS, Park KB, Kim DI, Kim YW, Kim MJ, Shin BS, Choo IW. Ethanol embolotherapy of hand AVMs. J Vasc Surg. 2011;53:725–31.CrossRefPubMedGoogle Scholar
  38. 38.
    Do YS, Park KB, Park HS, Cho SK, Shin SW, Moon JW, Kim DI, Kim YW, Chang IS, Lee SH, Hwang HY, Choo IW. J Vasc Interv Radiol. 2010;21:807–16.CrossRefPubMedGoogle Scholar
  39. 39.
    Jin Y, Lin X, Chen H, Hu X, Fan X, Li W, Ma G, Yang C, Wang W. Auricular AVMs: potential success of superselective ethanol embolotherapy. J Vasc Interv Radiol. 2009;20:736–43.CrossRefPubMedGoogle Scholar
  40. 40.
    Fan XD, Su LX, Zheng LZ, Zhang ZY. Ethanol embolization of AVMs of the mandible. AJNR Am J Neuroradiol. 2009;30:1178–83.CrossRefPubMedGoogle Scholar
  41. 41.
    Pekkola J, Lappalainen P, Vuola T, Klockars P, Salminen P, Pitkaranta A. Head and neck AVMs: results of ethanol sclerotherapy. AJNR Am J Neuroradiol. 2013;34:198–204.CrossRefPubMedGoogle Scholar
  42. 42.
    Settecase F, Hetts SW, Nicholson AD, Amans MR, Cooke DJ, Dowd CF, Higashida RT, Halbach VV. Superselective intra-arterial ethanol sclerotherapy of feeding artery and nidal aneurysms in ruptured cerebral arteriovenous malformations. AJNR Am J Neuroradiol. 2015;37:692–7. Published online 12 Nov 2015CrossRefPubMedGoogle Scholar
  43. 43.
    Vogelzang RL, Attasi R, Vouchi M. Ethanol embolotherapy of vascular malformations: clinical outcomes at a single center. J Vasc Interv Radiol. 2014;25:206–13.CrossRefPubMedGoogle Scholar
  44. 44.
    Lee BB, Do YS, Yakes WF. Management of AVMs: a multidisciplinary approach. J Vasc Surg. 2004;39:590–600.CrossRefPubMedGoogle Scholar
  45. 45.
    Yakes WF. Arteriovenous malformations – how i treat them: alcohol. Ces Radiol. 2008;62:146–52.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Wayne F. Yakes
    • 1
  • Krasnodar Ivancev
    • 3
  • Robert L. Vogelzang
    • 2
  • Alexis M. Yakes
    • 1
  1. 1.The Yakes Vascular Malformation CenterEnglewoodUSA
  2. 2.Northwestern Medical CenterChicagoUSA
  3. 3.Division of Vascular SurgeryUniversity of Hamburg Medical CenterHamburgGermany

Personalised recommendations