Mein schwerster Fall

Arteriovenous malformations (AVM) are extremely challenging lesions that have, until recently, been very difficult to treat and almost impossible to cure. This article describes a case of a Yakes type IIIB AVM of the forearm in a patient who had been seen years earlier and was felt to be untreatable because of the risks of tissue necrosis. In the intervening years, the Yakes classification of AVMs, which marries classification to specific treatments, was devised and published. The new insights afforded by this classification scheme permitted safe and relatively straightforward ethanol embolization of the venous side of the lesion with rapid healing of the large forearm ulceration. This case illustrates one of the central insights which Yakes has made: the fact that many AVMs can be attacked and treated on the venous side with much lower complication rates and high rates of permanent obliteration and cure. The Yakes classification is a major advance in the management of AVMs.