Fig 1. Patient 1.

A, Lateral projection of the left external carotid arteriogram demonstrates a periorbital arteriovenous malformation supplied by the branches of the superficial temporal (black dotted arrow) and internal maxillary arteries (white dotted arrow, middle meningeal branch: white arrow).

B, Lateral projection of the left internal carotid arteriogram showing ophthalmic artery contribution to the supply of the arteriovenous malformation.

C, Lateral projection of the left internal carotid arteriogram during second session embolization, after completion of the embolization of the external carotid supply discloses the drainage of the ophthalmic supply (marked by the tip of the hemostatic clamp). This drainage vein was selectively punctured and embolized.

D, Native image of the venous phase of a postembolization left common carotid arteriogram showing the embolic cast. The defect within the embolic cast denoted with the solid white arrow is the point of balloon inflation. Embolic agent is also noted in the vein draining the ophthalmic supply (white dotted arrow).

E, Left common arteriogram after the final session of embolization shows almost total obliteration of the lesion angiographically.