Abstract: PURPOSE: To observe and evaluate the outcome of fibrin glue (FG) combined with pingyangmycin (PYM) for treatment of selected cervicofacial arteriovenous malformation (AVM). METHODS: Twenty-two patients with cervicofacial AVM were chosen and treated by embolism and sclerotherapy of FG combined with PYM from December 2012 to December 2016. Of the 22 cases, 15 underwent a direct percutaneous puncture of the nidus and injection of FG combined with PYM solely; 2 underwent an injection of FG combined with PYM into the facial artery in addition to direct injection in lesion. Six underwent surgical excision of the redundant fibrous connective tissue and residual lesions after the embolism and sclerotherapy. To observe the vital signs and symptoms after treatments. The therapeutic effect was evaluated by physical examination, ultrasonography with Doppler, computed tomography (CT) scan, and CT angiography. The follow-up time was from 6 months to 36 months(mean 18 months). RESULTS: Of 22 patients, 17 were male and 5 were female, ranging in age from 19~74 years（mean,28 years）. Eighteen of 22 lesions (81.8%) showed greater than 90% reduction, whereas another 4 (18.2%) exhibited greater than 50% reduction. Transient white or cyan purple alteration in the skin occurred during the course treatment, indicating tissue ischemia or obstruction of draining veins. Superficial skin necrosis occurred and thin crust formed in forehead of 1 patient, and superficial mucous ulcer occurred in 2 patients and healed on its own. Three patients were found to continue growth during follow-up. CONCLUSIONS: Application of fibrin glue combined with PYM for the embolism and sclerotherapy of selected cervicofacial AVM appears to be safe and effective. It offers broad prospects especially for the treatment of locally expanded AVM.

Key words: Arteriovenous malformations, Pingyangmycin, Fibrin glue, Sclerotherapy, Embolism