Endovascular Treatment for Craniofacial Arteriovenous Fistula/Malformation

Objective: To introduce our experience of endovascular treatment for craniofacial arteriovenous fistula/malformation (AVF/M). Methods: We retrospectively analyzed the medical records of 13 patients (7 females and 6 males) with craniofacial AVF/M who were treated between 2001 and 2017 in our institution. We classified into three categories including single AVF (sAVF), multiple AVF (mAVF), and arteriovenous malformation (AVM). Treatment plans included 1) curative embolization, 2) preoperative embolization, and 3) palliative embolization. These strategies were decided by the discussion with plastic surgeons in every individual case. Results: Complete cure by embolization alone was obtained in all six patients with sAVF, in two among three patients with mAVF, and in none among four patients with AVM. Curative embolization was aimed at in eight patients, and complete cure obtained in all eight patients. Preoperative embolization was aimed at in three patients, and three patients resulted in total resection by surgery after successful partial embolization. Palliative embolization was aimed at in two patients, and these patients were kept in a stable condition after partial embolization. No permanent complications related to embolization were counted. Conclusion: Endovascular treatment for craniofacial AVF/M is safe and effective treatment, especially in the case with sAVF.