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Ethanol embolotherapy of pelvic arteriovenous malformations: an initial experience.

Bae S, Do YS, Shin SW, Park KB, Kim DI, Kim YW, Cho SK, Choo SW, Choo IW - Korean J Radiol (2008 Mar-Apr)

Bottom Line: The therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms, as well as the degree of devascularization observed on post-procedural angiography.Seven (88%) of eight patients were cured of their AVMs and one patient (12%) displayed improvement.Major complications were seen in two patients (25%).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: We retrospectively assessed the results of performing ethanol embolization for pelvis arteriovenous malformations (AVMs).

Materials and methods: During the past 10 years, eight patients (8 females, age range: 27-52 years) with AVMs in the pelvic wall (n = 3) and uterus (n = 5) underwent staged ethanol embolizations (range: 1-5, mean: 2.5) under general anesthesia. Ethanol embolization was performed by the use of the transcatheter and/or direct puncture techniques. Clinical follow-up was performed for all of the patients, and imaging follow-up was available for seven patients. The therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms, as well as the degree of devascularization observed on post-procedural angiography.

Results: During the 20 sessions of ethanol embolization, the solitary transarterial approach was used 14 times, the transvenous approach was used three times and direct puncture was used once. For two patients, the transarterial and transvenous or direct puncture approaches were used together in one session. For four patients, ethanol and coils were used as embolic agents, and n-butyl cyanoacrylate (NBCA) and ethanol were used in one patient. Seven (88%) of eight patients were cured of their AVMs and one patient (12%) displayed improvement. Major complications were seen in two patients (25%).

Conclusion: Ethanol embolization is effective for the treatment of pelvic arteriovenous malformations, though there is a chance of a major complication.

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Related in: MedlinePlus

34-year-old woman (patient 1) with right pelvic wall arteriovenous malformations.A-C. Posteroanterior pelvic angiogram shows arteriovenous malformations with multiple feeding arteries from right internal and external iliac arteries, nidus (arrows) and large draining vein (arrowhead) to right ovarian vein.D, E. After three sessions of ethanol treatment and coil embolizations, arterial and venous phases of posteroanterior angiogram show complete obliteration of arteriovenous malformations.
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Figure 1: 34-year-old woman (patient 1) with right pelvic wall arteriovenous malformations.A-C. Posteroanterior pelvic angiogram shows arteriovenous malformations with multiple feeding arteries from right internal and external iliac arteries, nidus (arrows) and large draining vein (arrowhead) to right ovarian vein.D, E. After three sessions of ethanol treatment and coil embolizations, arterial and venous phases of posteroanterior angiogram show complete obliteration of arteriovenous malformations.

Mentions: Seven (87.5%) patients were cured and one patient (12.5%) had improvement of the AVMs (Fig. 1). Ethanol embolization was considered an effective treatment for all the cases. Except for one patient, the AVMs were totally devascularized, as was demonstrated on the follow-up imaging studies. One patient who achieved improvement did not want further treatment. All the patients showed complete or partial resolution of their clinical symptoms and signs.


Ethanol embolotherapy of pelvic arteriovenous malformations: an initial experience.

Bae S, Do YS, Shin SW, Park KB, Kim DI, Kim YW, Cho SK, Choo SW, Choo IW - Korean J Radiol (2008 Mar-Apr)

34-year-old woman (patient 1) with right pelvic wall arteriovenous malformations.A-C. Posteroanterior pelvic angiogram shows arteriovenous malformations with multiple feeding arteries from right internal and external iliac arteries, nidus (arrows) and large draining vein (arrowhead) to right ovarian vein.D, E. After three sessions of ethanol treatment and coil embolizations, arterial and venous phases of posteroanterior angiogram show complete obliteration of arteriovenous malformations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627228&req=5

Figure 1: 34-year-old woman (patient 1) with right pelvic wall arteriovenous malformations.A-C. Posteroanterior pelvic angiogram shows arteriovenous malformations with multiple feeding arteries from right internal and external iliac arteries, nidus (arrows) and large draining vein (arrowhead) to right ovarian vein.D, E. After three sessions of ethanol treatment and coil embolizations, arterial and venous phases of posteroanterior angiogram show complete obliteration of arteriovenous malformations.
Mentions: Seven (87.5%) patients were cured and one patient (12.5%) had improvement of the AVMs (Fig. 1). Ethanol embolization was considered an effective treatment for all the cases. Except for one patient, the AVMs were totally devascularized, as was demonstrated on the follow-up imaging studies. One patient who achieved improvement did not want further treatment. All the patients showed complete or partial resolution of their clinical symptoms and signs.

Bottom Line: The therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms, as well as the degree of devascularization observed on post-procedural angiography.Seven (88%) of eight patients were cured of their AVMs and one patient (12%) displayed improvement.Major complications were seen in two patients (25%).

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Objective: We retrospectively assessed the results of performing ethanol embolization for pelvis arteriovenous malformations (AVMs).

Materials and methods: During the past 10 years, eight patients (8 females, age range: 27-52 years) with AVMs in the pelvic wall (n = 3) and uterus (n = 5) underwent staged ethanol embolizations (range: 1-5, mean: 2.5) under general anesthesia. Ethanol embolization was performed by the use of the transcatheter and/or direct puncture techniques. Clinical follow-up was performed for all of the patients, and imaging follow-up was available for seven patients. The therapeutic outcomes were established by evaluating the clinical outcome of the signs and symptoms, as well as the degree of devascularization observed on post-procedural angiography.

Results: During the 20 sessions of ethanol embolization, the solitary transarterial approach was used 14 times, the transvenous approach was used three times and direct puncture was used once. For two patients, the transarterial and transvenous or direct puncture approaches were used together in one session. For four patients, ethanol and coils were used as embolic agents, and n-butyl cyanoacrylate (NBCA) and ethanol were used in one patient. Seven (88%) of eight patients were cured of their AVMs and one patient (12%) displayed improvement. Major complications were seen in two patients (25%).

Conclusion: Ethanol embolization is effective for the treatment of pelvic arteriovenous malformations, though there is a chance of a major complication.

Show MeSH
Related in: MedlinePlus