Embolization of Vascular Malformations in Head and Neck Regions (original) (raw)
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Embolization of vascular malformations in head and neck regions. A single center experience
Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2004
The purpose of this study is to determine the effectiveness of embolization of each type of vascular malformation. Thirty three patients with a diagnosis of vascular malformations in head and neck regions who were treated by embolization at Siriraj Hospital, Thailand, between 1997-2002 were reviewed retrospectively. There were 19 arteriovenous malformations (AVMs), two arteriolar-capillary types, ten venous malformations, one veno-lymphatic malformation and one mixed capillary and venous types. The goal of treatment is to restore function and to prevent bleeding complications with particularly good cosmetic results. The technique and therapeutic agents depended on the types and flow characteristics of each malformation. Transarterial embolization with N-butyl cyanoacrylate were used in AVMs, unless no arterial route approach, then direct puncture was tried. This was carried out in five patients with AVMs. Polyvinyl alcohol was used in two capillary lesions. All venous malformations ...
Vascular, 2021
OBJECTIVE Current data on the nature and rate of major complications for embolo-sclerotherapy (EST) of vascular malformations are scarce. However, even fewer studies focus on vascular malformations specific to the head and neck, which confer an increased specific risk of airway compromise, neurologic and ophthalmologic injury. More understanding is required surrounding the type and incidence of complications to improve treatment planning and informed consent. Therefore, this study aimed to review major complications secondary to EST of head and neck vascular malformations over a 5-year period in a single specialized multidisciplinary centre for vascular anomalies. METHODS All interventions were decided by the multidisciplinary team. Demographic, procedural and complication data between 1st January 2013 and 31st December 2017 were prospectively documented in a dedicated database and analysed. EST of high-flow vascular malformations (HFVMs) was performed by selective catheter angiogra...
Endovascular treatment of head and neck arteriovenous malformations
Neuroradiology, 2014
Aim To present the long-term angiographic and subjective results of patients with head and neck arteriovenous malformations (HNAVMs) after endovascular treatment. Methods We retrospectively analyzed the medical files of 14 patients with HNAVM who were treated between 2000 and 2014. The treatment of choice was a transarterial superselective microcatheter-based approach followed by embolization using liquid embolic agents. The patients were asked to answer a quality of life questionnaire about the following symptoms before and after treatment: pain, functional impairment, cosmetic deformity, impairment in daily life, and bleeding. Results Complete or >90% closure of the AVM was achieved in 6 of 14 patients (43%). >50% shunt reduction was achieved in 10 patients (71%). Three complications were encountered in a total of 86 interventional procedures. Six patients presented with bleeding which was cured in all cases (100%). Four of the 14 patients (29%) specified pain which was resolved in two of them. Another six patients (43%) presented with functional impairment; four were cured and two noted an improvement. All 14 patients presented with cosmetic concerns; four were cured and eight experienced a clearly visible improvement. Nine of 13 patients (69%) presented with impairment in daily life which was resolved in five patients and four reported an improvement. Conclusions Endovascular embolization is a welltolerated therapy for HNAVM with a low complication rate. Good angiographic results, positive subjective results, and improvement in different aspects of quality of life can be achieved.
Arteriovenous Malformations: Clinical Aspects and Surgical Results
International Journal of Cardiovascular and Thoracic Surgery, 2018
Arteriovenous malformations (AVM) are vascular malformations, broadband, formed of arterial and venous dysmorphic vessels interconnected directly without transition in a capillary bed. Arteriovenous malformation surgery is particularly demanding owing to the need to control bleeding. This is probably one of the most critical moments of arteriovenous malformation surgery. The purpose of this study is to analyzed the clinical aspects and evaluate the results of surgery in the treatment of these AVMs. This is a retrospective and descriptive study that took place in Dakar over a period from January 2004 to December 2017 on patients operated for arteriovenous malformations. The total number of our series was 11 cases. These AVMs represented 32.35% of all tumors and vascular malformations operated during this period. The mean age at surgery was 25 years old [1 year-56 years old]. A male predominance was noted with 7 male to 4 female (sex ratio 1.75). The average time of consultation was 8.3 years [1 months-30 months]. The main reason for consultation was the appearance of a mass in 11 cas. We noted a notion of traumatism or recent surgery were done in 4/11 before the onset of symptoms. The location of the lesions was at the head or the face (5 cases), neck (1 case), the upper member (2 cases), the lower member (3 cases). No multiple location were noted. After physical examination, two patients were classified Schobinger stage 1, stage 2 in 7 cases, 2 cases in stage 3. No patient was classified stage 4. The vascular Doppler ultrasound was performed in 10 cases (91%) and allowed to confirm the diagnosis in 10 cases. The CT angiography was performed in 8 cases (73%). It elicited the feeding artery and draining veins, the number of nidus and topography. We found 6 truncal AVM and 5 extratruncal including 4 limited. A first embolization was performed in 2 cases (18.2%). A one-stage surgery was performed in 7 cases and two times in 4 cases. The average hospital stay was 15 days [3 days-60 days]. The average healing time was 18 days [15 days-30 days]. Operative mortality as early mortality was zero. Late mortality was zero. The average follow-up time was 50.3 months [2 months-96 months]. In recent years, the multidisciplinary approach of tumors and vascular malformations has made important advances in the delineation of nosological frameworks and in the understanding of the natural history and structure of these complex lesions. This is why the treatment of these AVMs requires a multidisciplinary consultation exchange between vascular surgeons, plastic surgeons, interventional radiologists and anesthetists.
Management of Head and Neck Arteriovenous Malformations -Team work Counts
Purpose: To demonstrate the management protocol in head and neck vascular malformation Methods: This is a retrospective review of 12 patients of arteriovenous malformation managed at a teaching hospital. Medical records were examined for age at first diagnosis, disease course, prior treatments, and age at presentation, management, therapeutic outcomes, impact on quality of life and photograph at time of presentation. Results: Twelve patients with head and neck arteriovenous malformation presented to our centre. There was equal distribution of males and females with an average age of presentation being 24 years (range 13-40 years). Ten patients out of 12 underwent embolization which was followed by surgery. Complete excision was achieved in eight cases while partial resection was achieved in two cases. Three patients had complications while getting treated. Conclusions: Head and neck AVM can be presented as expansile, invasive and locally aggressive lesions which require detailed evaluation and multidisciplinary approach for treatment.
Head & Neck, 2013
Background. There is no easy road map for venous malformations (VMs) of the head and neck according to which treatment modality can be chosen. The purpose of this study was to identify different types of VMs of the head and neck based on clinical, histopathology, MRI, and venography findings that help in specification of different treatment modalities. Methods. Sixty-nine patients with VMs of the head and neck were included in this study. Results and Conclusion. Our results proposed a diagnostic approach for VMs of the head and neck. MRI, venography, and clinical examination had important impact in decision-making, whereas histopathology had no impact. A management approach has been suggested for each type and its subtypes. V
Understanding venous malformations of the head and neck: a comprehensive insight
Medical Oncology, 2017
Venous malformations (VMs) are congenital vascular malformations. They are very often misnamed and thus incorrectly managed. The aim of the present paper is to provide the reader with the most updated literature available and to offer a detailed description of each single aspect of this disease. In detail, the paper discusses the epidemiology, the embryological origins and the physiopathology of VMs. Then, the clinical features of sporadic, inherited and syndromic VMs are discussed. The instrumental diagnosis is presented, and the role of US, CT, MRI and phlebography is pointed out. Differential diagnoses with other vascular malformations and tumors are described. The clinical session ends with the staging of VMs relying on MRI and rheological features. All aspects of treatment are described: conservative measures, medical treatment, sclerotherapy, laser and surgery are thoroughly discussed. A section is reserved to bony VMs. Their clinical aspects and the appropriate treatment are presented.
Management strategy for facial arteriovenous malformations
Indian Journal of Plastic Surgery, 2008
Arteriovenous malformations (AVMs) are uncommon errors of vascular morphogenesis; haemodynamically, they are high-ß ow lesions. Approximately 50% of AVMs are located in the craniofacial region. Subtotal excision or proximal ligation of the feeding vessel frequently results in rapid progression of the AVMs. Hence, the correct treatment consists of highly selective embolisation (super-selective) followed by complete resection 24-48 hours later. We treated 20 patients with facial arteriovenous malformation by using this method. Most of the lesions (80%) were located within the cheek and lip. There were no procedure related complications and cosmetic results were excellent.