A young man presented with pulsatile swelling of the left pinna, with reddish brown skin discoloration.
He was diagnosed to have arteriovenous malformation and was taken up for  DSA and embolisation under local anesthesia.
DSA showed a high flow AVM with a large fistula. This was then catheterized with a Progreat 2.7 Fr microcatheter, considering the large size of the feeder and the macro-fistula. Embolisation was done with 20% nBCA-lipiodol mixture. Complete exclusion of the AVM was achieved.
There was subsequently blackening of the skin of the earlobe, which necrosed and fell off, it was conservatively managed, with normal smooth skin formation over the ulcerated area and near comparable appearance with the opposite pinna. However there was some redness present in the mid-pinna, which was not explained, and was left behind. This patient is now in follow up since three years.