Cryoablation in fibro-adipose vascular anomaly (FAVA): a minimally invasive treatment option

Shaikh, Raja; Alomari, Ahmad I.; Kerr, Cindy L.; Miller, Patricia E.; Spencer, Samantha A.

doi:10.1007/s00247-016-3576-0

Cited by 59 publications

(36 citation statements)

References 19 publications

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“…Surgical excision or debulking can be difficult with the depth of involvement and the diffuse and infiltrative growth pattern. Cryoablation was recently reported to be a useful, minimally invasive option in 20 patients but depends upon the availability of an argon gas–based cryoablation system …”

Section: Discussionmentioning

confidence: 99%

“…Repeat MRI after 3 months showed a 10% reduction in the size of the Cryoablation was recently reported to be a useful, minimally invasive option in 20 patients but depends upon the availability of an argon gas-based cryoablation system. 3 Although the cause of FAVA has not been delineated, the PIK3CA-related overgrowth spectrum includes a group of disorders with fibroadipose overgrowth and infiltration into muscle and vascular malformations. 4,5 Sirolimus, an inhibitor of the mammalian target of rapamycin, has been shown to improve a range of vascular anomalies.…”

Section: Patientmentioning

confidence: 99%

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Fibroadipose vascular anomaly treated with sirolimus: Successful outcome in two patients

Erickson

McAuliffe

Blennerhassett

et al. 2017

Pediatric Dermatology

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Fibroadipose vascular anomaly (FAVA) is a rare, complex mesenchymal malformation combining fibrofatty replacement of the affected muscles and slow-flow vascular malformation. The condition is characterized by localized swelling, severe pain, phlebectasia, and contracture of the affected limb. Treatment paradigms are not well established for this rare, recently recognized condition. We report two cases of FAVA in which treatment with sirolimus produced rapid, dramatic improvement in pain and quality of life.

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Section: Discussionmentioning

confidence: 99%

Section: Patientmentioning

confidence: 99%

Fibroadipose vascular anomaly treated with sirolimus: Successful outcome in two patients

Erickson

McAuliffe

Blennerhassett

et al. 2017

Pediatric Dermatology

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“…Previous clinical experiences in the literature describe the frequent use of sclerotherapy and percutaneous cryoablation procedures for FAVA [12][13][14] and the high risk of blood loss and nervous system damage related to primary surgery in FAVA [6]. Thus, the multidisciplinary team proposed an original hybrid treatment strategy of primary percutaneous ethanol embolization of the FAVA and a secondary surgical excision of the mass.…”

Section: Strategy Developmentmentioning

confidence: 99%

Hybrid treatment of fibroadipose vascular anomaly: A case report

Stillo¹,

Ruggiero

Fiores³

et al. 2020

Open Medicine

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BackgroundFirst identified in 2014, fibroadipose vascular anomaly (FAVA) is a very rare type of venous and lymphatic malformation. Marked by tough fibrofatty tissue in the extremities overtaking portions of the muscles, it is associated with constant pain and contracture of the affected extremity. There is a paucity of literature, and no guidelines on treatment procedure are available. This case highlights the role of hybrid treatment with primary ethanol percutaneous ethanol embolization and additional surgery for radicality in excision of FAVA lesions.Case summaryA 9-year-old girl with FAVA underwent the hybrid treatment. The achievements of complete excision, clinical response, and patient satisfaction in long-term follow-up were assessed. Following the hybrid treatment, the patient experienced significant improvement in pain. Concurrent symptoms of physical limitation, leg swelling, and skin hyperesthesia also improved. The clinical benefit, supported by postoperative physiotherapy, was well stabilized at 6-month follow-up, resulting in complete patient satisfaction at 12- and 36-month follow-ups. No major complications were encountered.ConclusionEthanol embolization plus surgery is a safe, effective, and long-term hybrid treatment of symptomatic FAVA lesions.

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“…FAVA, a recently recognized type of venous malformation, exhibits fibro-fatty infiltration of the muscles, unusual pain and phlebectasia, and contracture of the affected limb. 9 Conventional treatments like sclerotherapy and local injection of steroid offer none or very transient relief. Surgical resection can be effective but has a longer recovery and increased risks.…”

Section: Cryoablation In Low-flow Malformationsmentioning

confidence: 99%

“…5,6 Percutaneous cryoablation has been the most commonly used ablation modality with limited early experiences still emerging. [7][8][9][10] Strategies for Percutaneous Image-Guided Cryoablation in Vascular Anomalies…”

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confidence: 99%

Percutaneous Image-Guided Cryoablation in Vascular Anomalies

Shaikh

2017

Semin intervent Radiol

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Understanding and management of vascular anomalies has always been intriguing. These disorders exhibit an expected pattern of clinical presentation and progression, and characteristic imaging findings. Significant progress in understanding and treating patients with vascular anomalies has been made in the past quarter century. Newer multidisciplinary domains for treating these disorders with medical drugs and less invasive image-guided or surgical procedures are constantly evolving. Vascular anomalies can exhibit aggressive tumor-like behavior resulting in recurrence or persistent symptoms after treatment. Thermal ablation has been widely used in tumor treatment. This has generated interest on using thermal ablation for treating vascular anomalies. Percutaneous image-guided cryoablation is increasingly used for this purpose as compared with other ablation technologies. Availability of small caliber cryoprobes and the ability to monitor the freeze zone in real time have made this an attractive option to interventional radiologists. These experiences are relatively new and limited. It is helpful to understand the emerging role of this technology in the treatment of vascular anomalies.

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Cryoablation in fibro-adipose vascular anomaly (FAVA): a minimally invasive treatment option

Abstract: Image-guided percutaneous cryoablation is a safe and effective option for treatment of symptomatic FAVA lesions.

Cited by 59 publications

References 19 publications

Fibroadipose vascular anomaly treated with sirolimus: Successful outcome in two patients

Fibroadipose vascular anomaly treated with sirolimus: Successful outcome in two patients

Hybrid treatment of fibroadipose vascular anomaly: A case report

Percutaneous Image-Guided Cryoablation in Vascular Anomalies

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