Ethylene vinyl alcohol copolymer to treat an intracranial arteriovenous malformation in a dog

Abstract

A 6-year-old neutered male German shepherd dog was evaluated for obtundation, blindness, and bilateral exophthalmos. A magnetic resonance imaging scan of the brain was performed and identified an arteriovenous malformation (AVM) with several feeding arterial branches, and venous drainage through the cavernous sinus.Venous vessels rostral to the AVM were severely distended and extended into the retrobulbar spaces. Liquid embolization by injection of ethylene vinyl alcohol copolymer was performed from access points in the maxillary arteries and internal carotid arteries. No intraprocedural complications were encountered, and the dog was discharged the next day. Bilateral enucleation eventually was performed because of exposure keratopathy. At 31 months post-embolization, owners reported that the dog was doing very well clinically with high activity level and normal appetite, and the dog also appeared to be pain free. Although intracranial AVMs are very rare in companion animals, successful treatment using liquid embolization is possible and should be considered.

A French bulldog with rectal bleeding, anaemia and left hindlimb oedema due to arteriovenous malformations

“…Super-selective transcatheter embolisation has also been described as a common treatment of intestinal AVMs in humans (particularly AVMs causing lower gastrointestinal bleeding). 5,22,23 Transcatheter arterial embolisation for the treatment of neoplastic masses has also been described in dogs and cats, 24,25 as well as case reports of embolisation techniques used for AVMs in dogs including peripheral AVMs, 26,27 an intracranial AVM 28 and hepatic AVMs. [29][30][31] However, there are no current reports describing embolisation techniques for the treatment of canine intestinal AVMs.…”