Can Amputation be Justified for Extremity Arteriovenous Malformations? A Case Report and Scoping Review of Literature.
Dimitrios A Chatzelas, Theodosia N Zampaka, Georgios V Tsamourlidis et al.
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Case in brief
A 42-year-old man with a congenital arteriovenous malformation of the non-dominant hand presented with spontaneous, life-threatening bleeding. The lesion had progressed to Schobinger stage III despite previous embolization attempts. Emergency mid-forearm amputation controlled the hemorrhage and substantially relieved his pain. At two years after surgery, he had no recurrence and was reported to have excellent functional and psychological recovery.
What made this case unusual
The case illustrates amputation as a life-saving last-resort option for an advanced extremity AVM after prior embolization attempts, with reported functional and psychological recovery.
Diagnostic / clinical pearl
In an advanced extremity AVM with life-threatening hemorrhage and progression despite embolization, amputation may be considered as a last-resort means of controlling bleeding.
Why it matters
The report underscores the importance of multidisciplinary, patient-centered decision-making when weighing amputation for severe extremity AVMs.