Treatment Outcomes of Embolization for Peripheral Arteriovenous Malformations |
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| Institution: | 1. Department of Radiology and Nuclear Medicine, Radboudumc, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands;2. Department of Dermatology, Radboudumc, P.O. Box 9101, 6500 HB, Nijmegen, Netherlands;3. Department of Surgery, Division of Pediatric Surgery, Radboudumc-Amalia Children’s Hospital, Nijmegen, Netherlands;1. Department of Radiology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan;2. Department of Gastroenterology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan;1. Department of Surgery, Lenox Hill Hospital, Northwell Health System, New York, NY;2. The AVM Center of New York at Lenox Hill, Northwell Health System, New York, NY;1. Pediatric Section, Hospital Clínico Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 Murcia, Spain;2. Hospital Clínico Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 Murcia, Spain;3. Pediatric Section, Hospital Clínico Universitario Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, 30120 Murcia, Spain;4. Hospital General Universitario Reina Sofía, Avda. Intendente Jorge Palacios, 1, 30003 Murcia, Spain;1. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea;2. Department of Urology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea;3. Department of Obstetrics and Gynecology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea;4. Department of Surgery, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea |
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| Abstract: | PurposeTo evaluate treatment outcomes of embolization for peripheral arteriovenous malformations (AVMs) in a tertiary referral center where ethanol is the primary agent of choice.MethodsA retrospective study was performed of 93 patients (median age, 31 years; range, 2–66 years) with peripheral AVMs treated with embolization (n = 442; median, 2 per patient; range, 1–82) between January 2010 and July 2016. Ethanol was used in most cases (n = 428; 97%). AVMs were classified as type I (n = 3), type II (n = 57), type IIIa (n = 5), type IIIb (n = 15), and type IV (n = 13) according to the Yakes classification system. Effectiveness of embolization was based on AVM devascularization on angiography: 100% (total), 90%–99% (near-total), 70%–90% (substantial), 30%–70% (partial), and 0%–30% (failure). Complications were graded according to the Society of Interventional Radiology classification.ResultsIn 69% of patients, 70%–100% devascularization was achieved. Total and near-total occlusion of the nidus were more often achieved in AVMs of types I and IIIa (both 100%) than in AVMs of types II, IIIb, and IV (56%, 67%, and 39%, respectively; P = .019). A total of 109 complications were identified: 101 minor (22.9%) and 8 major (1.8%). Major complications included wounds (n = 5), false aneurysm (n = 1), finger contracture (n = 1), and severe pain (n = 1) requiring therapy. The patient complication risk was significantly affected by the number of procedures (relative risk = 2.0; P < .001). Age, AVM location, and angioarchitecture type did not significantly affect complication risk.ConclusionsAVM embolization resulted in 70%–100% devascularization in 69% of patients, with few major complications. This study indicates that the type of AVM angioarchitecture affects the number of procedures needed and the achievability of AVM devascularization. |
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| Keywords: | AVM"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"arteriovenous malformation CVM"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"congenital vascular malformation |
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