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February 1989

Ligation of an Arteriovenous Malformation With the Heifetz Clamp

Arch Ophthalmol. 1989;107(2):171. doi:10.1001/archopht.1989.01070010177015

To the Editor.  —We ligated an arteriovenous malformation of the orbit using a Heifetz aneurysm clamp and found the technique to have several advantages.

Report of a Case.  —A 60-year-old woman complained of headaches for one year. She noted intermittent "shooting pains" in the left eye. During this period she also noticed gradually progressive proptosis of the left eye.On examination, near vision measured J1 OU with a +2.00 addition. Her left upper and lower eyelids appeared full, with dilated superficial veins and episcleral venous congestion. Pulsations were palpable through the left upper eyelid. Hertel exophthalmometry readings were 12 OD and 19 OS. By applanation tonometry, intraocular pressures were 12 mm Hg OD and 26 mm Hg OS. Results of slit-lamp and fundus examinations were unremarkable.Cerebral arteriography disclosed a large arteriovenous (AV) malformation of the left orbit. The pattern of dye filling was most consistent with a dural AV

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