Endovascular management of peripheral congenital arteriovenous malformation and arteriovenous fistula in Nepal

Introduction: The management of peripheral arteriovenous malformations (AVMs) and arteriovenous fistula (AVF) remains challenging in Nepal due to their unpredictable behavior and high recurrence rate. Materials and Methods: This report describes cases of peripheral AVM and AVF. We report the case of a 20-year-old male with AVMs draining from a superficial femoral artery (SFA) with multiple feeders on the left lower thigh who underwent embolization of SFA feeders. Other case was a 60-year-old female with very high-flow AV fistula from the inferior gluteal artery with large venous varix of draining vein who underwent coil embolization of nidus followed by glue embolization. Results: Both patients got relieved of pain and significantly decreased mass n pulsation. The outcome was satisfactory without complication. Conclusion: Treatment for peripheral AVM and AVF is a challenge due to their unpredictable behavior. There is a wide plethora of embolic agents, each with its particular characteristics that makes it ideal for certain situations. Familiarity with these and their modes of use and action can help in selecting the correct agent depending on the goal of embolization.