Surgical excision of calcified intramuscular arteriovenous malformation of the leg after failed angioembolization

Abstract

Arteriovenous malformations (AVMs) can occur in any location but are more commonly seen in the brain. Surgical excision combined with embolization therapy is the preferred method of treatment. We had a young female with intramuscular AVM of left leg and the patient has already undergone sclerotherapy and embolization multiple times but has not been relieved of symptoms. We have excised the severely calcified stone-like AV malformation with ligation of the feeder artery. In this report, we have discussed the challenges associated with performing surgery post-angioembolization and the importance of titrating excision with the associated risk of functional disability due to loss of muscle tissue.