Background
AVMs may present at any age and are the least common vascular malformation diagnosed in children (69). An AVM is a high flow lesion and occurs when an artery directly connects to the venous system and bypasses the capillary beds. The natural history of these abnormal vascular connections is progressively ectatic veins due to the high velocity blood flow, with eventual rupture. Rupture is the most feared complication for any AVM and therefore intervention is almost always warranted. The rate of rupture is higher in children when compared to adults, making timely intervention of higher consideration (70). High flow through AVMs can lead to hypoperfusion, hypoxic ischemia, and pain, in a phenomenon known as steal syndrome (71).