Major Complex Pelvic Arteriovenous Malformation in a Patient with Down Syndrome

Abstract

Pelvic arteriovenous malformations (AVM) are rare, and the treatment of this condition presents an interesting challenge. We report the first case of a major AVM in a patient with Down syndrome which was revealed by a massive hematuria. Arteriography showed a bilateral complex iliac artery malformation. The first proximal embolization (unilateral) did not prevent bladder hemorrhage, and the second distal (bilateral) immobilization produced bladder necrosis. However, the patient died despite an emergency cystectomy.

Arteriovenous malformation of brain with stroke in Down syndrome: a case report

“…Vascular malformations of various sites have been described previously in association with Down syndrome,1 – 3 but we did not find any reports of hemiplegia due to arteriovenous malformation of brain in a patient with Down syndrome in literature. Abdominal venous malformations are probably the most frequent congenital vascular malformations in Down syndrome 2…”

“…Down syndrome is the commonest chromosomal disorder in children There have been few case reports of Down syndrome being associated with vascular malformations in the pelvis,1 abdomen and spine,2 – 4 but arteriovenous malformation of the brain has not been reported to date in association with Down syndrome. We report herein a child with Down syndrome who developed stroke (hemiparesis) due to an arteriovenous malformation in the brain.…”

Congenital Pelvic Arteriovenous Malformation Presenting with Urinary Retention: A Case Report

“…In the pelvis, congenital AVMs are rare, especially in male patients. Indeed, to our knowledge, only 20 cases of congenital pAVM in males have been reported in the English literature from 1966 to January 2010, based on a Medline search using the following keywords: arteriovenous malformation; MeSH terms: arteriovenous malformation and pelvis [1,[3][4][5] . Nor did we find any reported case presenting primarily with urinary retention.…”

Complications of Embolization

“…Necrosis of the skin, bladder, 131 or other intra-abdominal organs has also been described, and even ischemia of the spinal medulla may occur, most commonly when embolization of the arteries of the lumbar, sacral, or vertebral areas is necessary.…”