Parkes weber syndrome - NEJM
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A 77-year-old woman was referred for evaluation of fingertip ulcers. She had arteriovenous malformation of the left arm (Panel A) that had been present since childhood. Physical examination revealed hypertrophy, with a giant arteriovenous malformation involving her fingers, forearm, elbow, and upper arm. The malformation was pulsatile, with dilated veins and arteries and a palpable thrill. Small ulcerations were noted in the fingertips. There was no indication of cardiac failure. A magnetic resonance angiogram of the elbow, forearm and hand (Panel B) showed enlarged and tortuous arteries and veins, with several sites of aneurysmal dilatation throughout the imaged portion of the limb (Panel B, arrow) and multiple high-flow arteriovenous shunts. Parkes Weber syndrome consists of venous and capillary malformations and high-flow arteriovenous shunts, with overgrowth of the affected limb...

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