Use of the LigaSureTM in Cervicofacial Venous Malformation Excision (original) (raw)
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Staged endovascular and surgical treatment of slow-flow vulvar venous malformations
American Journal of Obstetrics and Gynecology, 2013
The objective of the study was to report our experience in a rare series of treated symptomatic slow-flow vulvar venous malformations (VVMs) using a staged, multidisciplinary approach. STUDY DESIGN: Consecutive patients with symptomatic lesions treated over a 7 year period (2005-2012) were followed up for technical success, resolution of symptoms, aesthetic outcomes, and complications. Direct endovenous sclerotherapy (DEVS) using sodium tetradecyl sulfate (STS) foam was performed in all patients under ultrasound and contrast-enhanced fluoroscopic guidance. Surgical excision and layered primary closure was performed within 24 hours after the last DEVS session.
The Professional Medical Journal
Objectives: To evaluate the efficacy and safety of the LigaSure vessel sealing system in Milligan – Morgan Haemorrhoidectomy and compare to conventional tools. Study Design: Randomized control trial. Setting: Department of surgery Bolan University of Medical and Health Sciences at Sandeman (prov) Hospital Quetta. Period: January 2017 to June 2018. Material & Methods: Randomized controlled study designed for comparison was carried out. Total 86 patients of both gender had grade III and IV hemorrhoids were enrolled and randomly divided in two groups. LigaSure group and Conventional group. After obtained institutional permission and informed consent all patients were prepared for surgery as per unit protocol. Patients of both groups were evaluated for operative time, per operative bleeding, post-operative pain, hospital stay, wound healing time, and time return to work. Data collected and analyzed on SPSS version 20. Results: Total 86 patients enrolled for study 58 (66.4%) males and 28...
Acta medica Lituanica, 2021
Introduction: Hemorrhage is one of the commonest and dreaded complications especially with pelvic surgeries. Gestational trophoblastic neoplasias (GTN) are notorious for their propensity to bleed torrentially and metastasis to vital organs. GTN is associated with an arterio-venous malformation (AVM) about 10-15% of the time, which can lead to bleeding after surgery or after complete remission. After the failure of conventional management with chemotherapy or surgery one is compelled to take another modality of management. One of such methods is the use of transcatheter artery embolization in cases of GTN or post-hysterectomy cases of GTN. Transcatheter artery embolization (TAE) was effective in controlling bleeding due to arterio-venous malformation in 96% of cases.Case: 46 years P2L2A5 (para 2, living issue 2, abortion 5) post-hysterectomy patient presented with bleeding from the vagina after surgery. Twice she underwent vaginal vault repair after hysterectomy but failed. Ultrasono...
Journal of Vascular Surgery, 1993
Purpose: Until recently, the accepted management of life-threatening complications of unresectable cervicofacial arteriovenous malformations (AVMs) has been ligation of the major feeding vessels, usually the branches or the main trtmk of the external carotid artery. Rapid enlargement of collateral vessels around the ligature is usually associated with an early return of symptoms. Percutaneous transcatheter embolization of the nidus of the arteriovenous malformation is now the preferred treatment for symptomatic AVMs that cannot be excised. Previous ligation of the main feeding vessels prevents catheter access and embolization therapy of the lesion. The purpose of this report is to describe our experience with the treatment of patients with symptomatic unresectable cervicofacial AVMs and previous external carotid artery ligation.
Treatment of Venous Malformations: The Data, Where We Are, and How It Is Done
Techniques in Vascular and Interventional Radiology, 2018
Venous malformations are the most common type of congenital vascular malformation. The diagnosis and management of venous malformations may be challenging, as venous malformations may be located anywhere in the body and range from small and superficial to large and extensive lesions. There are many treatment options for venous malformations including systemic targeted drugs, open surgery, sclerotherapy, cryoablation, and laser photocoagulation. This article reviews the natural history, clinical evaluation, imaging diagnosis, and treatment modalities of venous malformations.
Sclerotherapy to a large cervicofacial vascular malformation: A case report with 24 years' follow-up
Head & Neck, 2005
Background. Large craniofacial venous malformations frequently cause significant cosmetic and functional problems. Treatment of the lesions early in life helps to avoid these problems. We present a case of a large cervicofacial venous malformation. Methods. The patient was treated with a 5% benzyl alcohol solution of sodium morrhuate. The treatment was begun when the patient was 3 months of age, with a total of 23 injections. Results. The lesion had completely disappeared by age 10. No major complications were observed except a superficial tissue loss on the temporal region. It was healed by conservative treatment. There were no recurrences during the 14-year follow-up. Conclusions. It is difficult to conclude that this type of treatment is the best choice for patients with venous malformation on the basis of a single case. However, intralesional sclerotherapy should be kept in mind as a savior treatment option in cases of large venous malformations in anatomic regions that present challenges to both the surgeon and the patient. Intralesional sclerotherapy can be performed without serious complications if the sclerosing agent is selected and injected cautiously.
Hemorrhagic Complications after Endovascular Treatment of Cerebral Arteriovenous Malformations
American Journal of Neuroradiology, 2014
BACKGROUND AND PURPOSE: Intracranial hemorrhage is the most severe complication of brain arteriovenous malformation treatment. We report our rate of hemorrhagic complications after endovascular treatment and analyze the clinical significance and potential mechanisms, with emphasis on cases of delayed hemorrhage after uneventful embolization. MATERIALS AND METHODS: During a 10-year period, 846 embolization procedures were performed in 408 patients with brain AVMs. Any cases of hemorrhagic complications were identified and divided into those related or unrelated to a periprocedural arterial tear (during catheter navigation or catheter retrieval). We analyzed the following variables: sex, age, hemorrhagic presentation, Spetzler-Martin grade, size of the AVM, number of embolized pedicles, microcatheter used, type and volume of liquid embolic agent injected, and the presence of a premature venous occlusion. Univariate and multivariate multiple regression analyses were performed to identify risk factors for hemorrhagic complications. RESULTS: A hemorrhagic complication occurred in 92 (11%) procedures. Forty-four (48%) complications were related to a periprocedural arterial perforation, and 48 (52%) were not. Hemorrhagic complications unrelated to an arterial perforation were located more commonly in the cerebral parenchyma, caused more neurologic deficits, and were associated with worse prognosis than those in the arterial perforation group. Only premature venous occlusion was identified as an independent predictor of hemorrhagic complication in the nonperforation group. Premature venous occlusion was significantly related to the ratio of Onyx volume to nidus diameter. CONCLUSIONS: Higher injected volume of embolic agent and deposition on the venous outflow before complete occlusion of the AVM may account for severe hemorrhagic complications. ABBREVIATIONS: AP ϭ arterial perforation; EVT ϭ endovascular treatment; HC ϭ hemorrhagic complication; NAP ϭ non-arterial perforation; S-M ϭ Spetzler-Martin; V ea ϭ volume of liquid embolic agents