Hi Norma,
The institution where I used to work was a center for embolotherapy of
arterio-venous malformations (AVM), arteriovenous fistulas(AVM), and
venous malformation (VM). We routinely scanned patients pre and post
embolization. I've seen a number of venous malformations that do not have
an arterial pre-capillary component or communication. Venous
malformations may be extensive, with large multiple varix-type
components, or they may be small, with subtle channels and "sponge-like"
structures. Both types can be very disfiguring and can occur most
anywhere in the body. I have a handout , with additional references, that
describes these vascular malformations. I'd be glad to fax it to you.
Rob Daigle
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 -----Original Message-----
From: Norma VandenBerghe [SMTP:[log in to unmask]]
Sent: Wednesday, April 12, 2000 8:26 PM
To: Robd; UVMFLOWNET
Subject: A-V malformations


I have a question about using duplex US to identify and localize
congenital arterio-venous malformations.  I have had a few cases through
the years, and have not really had much luck with tracking the little
devils down.  I have been able to predict a couple of intracranial cases
based on the differences between the flow signals in the two carotid
arteries.  But in the extremities, as on the child I saw today with
hugely distended veins and even small venous ulcerations on his left
leg, they have remained elusive.  I looked at the entire arterial system
for low resistance or turbulence;  I looked at the entire venous system
for arterialized flow, pulsation, etc.  And found nothing.  No
difference compared to the same site on the unaffected right leg.  I
looked at iliacs and all the way down the leg.  I tried to just look for
abnormal color flow.  I looked with velocity scale set high.  Set low.
Gain up, down etc. Nothing.

Have others had more success than I have?  I feel like I must be
overlooking something.
Thanks!   Norma V.