Absolute Ethanol Embolization of Arteriovenous Malformations in the Periorbital Region

Su, Lixin; Jia, Renbing; Wang, De Ming; Lv, Mingming; Fan, Xindong

doi:10.1007/s00270-014-0993-z

Cited by 18 publications

(9 citation statements)

References 25 publications

(27 reference statements)

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“…Yates recommends experience with the use of ethanol, recognition of the nidus and knowledge of the vascular supply to nerves as tantamount to lowering complications with ethanol 20. Su et al described the treatment of 16 patients with periorbital AVMs with 99.7–66% ethanol 21. A total of 28 sessions were performed.…”

Section: Discussionmentioning

confidence: 99%

Embolization of palpebral and orbito-frontal fistulas: technical and anatomical considerations in treating high-flow superficial skin lesions with liquid embolics

Samaniego

Fisher

Hasan

et al. 2017

J NeuroIntervent Surg

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The treatment of palpebral and periorbital fistulas may be challenging due to the presence of multiple anastomosis with eloquent ophthalmic and intracranial vascular territories. Moreover, cosmetic and functional characteristics of this area pose unique challenges to open surgical approaches and endovascular therapy. We review the advantages and disadvantages of different liquid embolics in treating palpebral and periorbital fistulas as we describe three successfully treated cases. Moreover, we describe important anatomical landmarks that should be considered at the time of treatment of these lesions.

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Section: Discussionmentioning

confidence: 99%

Embolization of palpebral and orbito-frontal fistulas: technical and anatomical considerations in treating high-flow superficial skin lesions with liquid embolics

Samaniego

Fisher

Hasan

et al. 2017

J NeuroIntervent Surg

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“…All radiologists performed masked assessments. The degree of devascularization at angiography was defined with a four-point grading system (grade I, ,50% devascularization; grade II, 50%-75% devascularization; grade III, 76%-99% devascularization; and grade IV, 100% devascularization) (14,(27)(28)(29)31). Three surgeons (X.L., Y.J., H.C.; 22, 10, and 8 years of experience, respectively, in the evaluation of AVMs) working in consensus evaluated the clinical outcomes (ie, complete resolution, improvement, no change, or worsening) and complications (14,25,(27)(28)(29)(30).…”

Section: Outcome Evaluationmentioning

confidence: 99%

Treatment of Early-stage Extracranial Arteriovenous Malformations with Intralesional Interstitial Bleomycin Injection: A Pilot Study

et al. 2018

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Purpose To assess the efficacy and safety of intralesional interstitial bleomycin injection in the treatment of early-stage (Schobinger stage I or II) extracranial arteriovenous malformations (AVMs). Materials and Methods This prospective study involved 34 patients with early-stage AVMs, as defined by the Schobinger staging system. The patients received intralesional interstitial bleomycin injected at a maximum dose of 15 000 IU or 1000 IU per kilogram of body weight for children who weighed less than 15 kg per procedure for a total of 6 months (once every month). Therapeutic outcome was evaluated by the degree of devascularization at angiography and the clinical outcome 3 months after the last treatment. Further follow-up was evaluated based on further clinical outcome. Adverse events were recorded according to the Society of Interventional Radiology classification. Results Of the 34 patients with early-stage AVM, 32 (mean age, 20.5 years; 24 female [75%]) completed the study. The results showed that 27 (84.4%, 95% confidence interval [CI]: 71.1, 97.7) patients were responsive to bleomycin injection, including nine (28.1%) with a complete response. Four (12.5%) patients showed no response, and one (3.1%) patient experienced worsening 3 months after the last treatment. During further follow-up (mean follow-up time, 20.7 months; range, 5-28 months), the outcome remained stable in 31 (96.9%) of the 32 patients. A major complication, anaphylactic shock, was observed in one (3.1%, 95% CI: 0, 9.5) patient. Common minor complications included hyperpigmentation, nausea, pruritus, and bullae. Conclusion Intralesional interstitial bleomycin injection is a feasible approach for early-stage AVMs and yields safe and effective outcomes. RSNA, 2017.

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“…Surgical ligation of feeding arteries or partial excision of AVM lesions can potentially induce the recurrence or worsening symptoms 11 . Endovascular interventions have been used to treat AVMs that have a high risk of surgery and/or surgically inaccessible lesions, especially in the periorbital and orbital regions 12,25 . TransOphA embolization using embolic agents (PVA particles, Gelfoam powder, n-Butyl-2-Cyanoacrylate (NBCA) Glue, and Onyx) has been reported to be successfully used to treat various vascular malformations and neoplastic lesions fed by OphA, including intraorbital arteriovenous stulas 4 , AVMs in craniofacial regions 3 , and meningiomas 28 15, 29 .…”

Section: Introductionmentioning

confidence: 99%

Trans-ophthalmic Arterial Ethanol Embolotherapy for Arteriovenous Malformations: A Single Centre Experience

Li¹,

Yang²

2021

Preprint

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Background and purposeArteriovenous malformations (AVMs) derived ophthalmic artery (OphA) branches are not common, however, their management is very challenging. We aimed at evaluating the safety and efficacy of Trans OphA ethanol embolotherapy for these lesions.Materials and methodsWe retrospectively reviewed 26 patients with AVMs fed by OphA, who underwent transOphA embolization using ethanol from February, 2015 to December, 2019. Sixty-six transOphA embolotherapy procedures (range, 1-4 procedures; mean, 2.5 procedures) were performed. Degree of devascularization, visual field, visual acuity, and quality-of-life outcomes were compared and analyzed at follow ups (mean, 32.6 months; month range 10-60). Complications were recorded.ResultsTwenty of the 26 patients (77%) reported complete or >90% AVM devascularization while six patients (23%) showed >70% devascularization. Eleven patients (42%) presented with visual acuity impairments with 4 complete relief, 6 improvements. Eight patients (42%) presented visual field defects with 4 complete relief, 3 with improvements. Ten patients (38.4%) presented with diplopia and exophthalmos with 2 complete relief, 6 major improvements. Bleeding was controlled in all cases (100%). All patients (100%) exhibited cosmetic deformities with 17 being completely relieved. Moreover, all patients (100%) exhibited impaired daily life, which was resolved in 21 patients with 5 patients reporting major improvements. No vision loss, death, or permanent disability in all patients.ConclusionsTransOphA ethanol embolotherapy was found to be efficacious, safe and it achieved symptomatic resolution or improvement of AVMs fed by OphA with acceptable complications without the risk of visual impairment.

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Absolute Ethanol Embolization of Arteriovenous Malformations in the Periorbital Region

Abstract: Ethanol embolization is efficacious and safe in the treatment of AVMs in the periorbital region and has the potential to be accepted as the primary mode of therapy in the management of these lesions.

Cited by 18 publications

References 25 publications

Embolization of palpebral and orbito-frontal fistulas: technical and anatomical considerations in treating high-flow superficial skin lesions with liquid embolics

Embolization of palpebral and orbito-frontal fistulas: technical and anatomical considerations in treating high-flow superficial skin lesions with liquid embolics

Treatment of Early-stage Extracranial Arteriovenous Malformations with Intralesional Interstitial Bleomycin Injection: A Pilot Study

Trans-ophthalmic Arterial Ethanol Embolotherapy for Arteriovenous Malformations: A Single Centre Experience

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