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FIG 2. A, Frontal view of a superselective left ascending pharyngeal arteriogram shows rapid shunting flow through the AVM nidus and retrograde flow in the draining vein portion of the AVM down toward the carotid-jugular fistula immediately after model construction. Straight coils were used to occlude right-sided neck branches during model construction. Arrows indicate direction of flow.
B, Frontal left common carotid arteriogram shows features of the same AVM model as in A but 2 months later. Note dilatation and some elongation of the component vessels as well as marked dilatation of the external jugular vein.
C, Frontal left common carotid arteriogram shows features of the 6-month-old AVM model. Note dilatation and elongation of its component vessels and the overall coarse pattern of nidus microvessels. In this swine, the muscular branch of the right ascending pharyngeal artery (arrow) was not occluded during model construction owing to temporary vasospasm, which prevented access. This allowed the delayed recruitment of blood via anastomoses with the namesake contralateral artery, in parallel with shunting across the AVM nidus.
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