Approaching Facial AVM via neck artery!

Hello everyone. I would like to know if anyone has had or heard of embolization procedure for a facial AVM via neck artery. To the best of my knowledge the usual procedure involves insertion of a catheter from the thigh, however I am interested to know if the catheter can be inserted from the neck. If yes... what is the ratio of successful treatment?

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It is too dangerous to insert the catheter at the neck, saqib. If there is a problem, the docs want it to show up in the hip, not in the neck.

hello dancermom. Thanks for your response. I am sorry I don't get it. Why does the catheter need to appear in the hip? I thought that perhaps approaching a facial AVM from the neck is supposed to be a shorter and safer path. I request some clarification.

We were told at Hopkins that bleeding from the carotid would be a more serious situation than bleeding from the femoral artery.

I have never heard of facial avm embolization being done with catheter entering at the neck.

This is just a guess on my part. I think they'd be very wary of trying it this way because if an AVM is in the face it has a chance that it is connected to one of those arteries of the neck. It's not until they add the contrast dye to the AVM that they can know for sure what vessels and arteries are affected by AVM.
I think it would be dangerous to try and puncture an artery that is AVM affected because there is a possibility of increased (more than usual) blood flow to the area and a patient could get in to serious trouble.

Hi! Had an angiogram done this way when I was a teenager, it was very uncomfortable and difficult for me, the doctors, all of us. My doctor indicated just the other day that going in through the neck artery is now no longer an option pursued. He did not fully explain why but he acted like it was common knowledge among doctors/surgeons that treat AVMs so I would get other opinions. Steve

That makes sense. I believe that high proximity to the brain and eyes does make the carotid approach risky. :(

Hello Kim. Actually my CT angiogram does reveal connection of my AVM to the left carotid. That is why I was interested to know that if we have a path from the neck, why not approach from there. But yes it is risky as you have pointed out due to possibility of blood flow surge in the vicinity. It would be interesting to know if that potential surge can be controlled to safely manage the AVM.

Hey Steve! First of all I salute you for your courageous struggle against AVM. I can relate to your story because I know that feeling of going through multiple surgeries and then coming to know that it is never cured! I am glad to see that your AVM doesn't deform your lip or cheek. My AVM is more concentrated at my left upper lip and jaw. Fortunately I have never had any major bleeds, dizziness or blackouts but it deforms my lip on one side and it can be a hurdle in day to day routine. Anyway I had a CT angiogram last year, now they inject the dye from the wrist which I am sure is much less painful than than the way you had it done back then.

If you do find any second opinion regarding approaching AVM from the neck please do share the information. Thanks.

Hi, I had one done as a teenager 30 or so years ago through my neck; doctors had a hard time though going through the neck, it was very uncomfortable for me and hard on them. My current physician, a neurosurgeon who has been trained on all the latest techniques and current strategies regarding AVM mentioned to my wife and I that entering through the neck is not a recommended method anymore, but did not explain why. So, based on what he shared with us, I would certainly question if your doctor is suggesting that approach as mine made it sound like it was a NO GO and that the AVM community of doctors are all aware of that! I do not want to alarm you, but depending on your doctors experience level treating AVMs, unless it is Dr. Yakes or Dr. Suen, or one of the other well renown doctors that are talked about on this site and who deal with AVMs all the time, I would seriously question any doctor taking that approach. r/Steve