Transcatheter Embolo-sclerotherapy of High Flow Arteriovenous Malformations

Document Type : Original Article

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Abstract

Background: Vascular malformations can be classified according to endothelial characteristics and flow dynamics of the lesions, on which the principles of treatment are based. Percutaneous injection of sclerosing agents such as ethanol or sodium tetradecyl sulfate is the mainstay treatment for the more prevalent low-flow or venous vascular malformations. In contrast, symptomatic high-flow arteriovenous malformation (AVM) generally requires transcatheter embolo-sclerotherapy with or without surgery to control the disease process.
Objective: To evaluate the safety and efficacy of endovascular management of high flow arteriovenous malformation by embolization and sclerotherapy.
Patients and methods: This study was conducted at Mansoura University Hospitals, we included a total of 18 cases diagnosed with high flow AVM. All cases were subjected to complete history taking, thorough physical examination, and routine laboratory investigations. Also, duplex ultrasound (US) and computed tomography (CT) angiography were ordered for all cases.
Results: The mean age of the included cases was (26.73 years (range, 8 – 60 years). Males represented 61.11% of these cases, while the remaining patients were females. As regard the clinical result, success was achieved in 16 cases (61.11%). Only two cases had poor clinical result (11.11%). Transient ischemia was encountered in 2 cases (11.11%). Other complications included ulceration (5.56%), foot gangrene (5.56%), hand ischemia with amputation (5.56%), contracture scar (5.56%), and necrosis with transient PE (6.7%). With a mean follow up period of 26 months (range, 6 – 36 months), 16 cases showed very good outcome (88.89%), one case had good outcome (5.56%), while the remaining case had poor outcome (5.56%).
Conclusion: Embolo-sclerotherapy appears to be safe and effective intervention for high flow arteriovenous malformations.
 

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The Egyptian Journal of Hospital Medicine
Volume 83, Issue 1
April 2021
Pages 916-921

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