Surgical Treatment with or without Embolotherapy for Arteriovenous Malformations

Abstract

Objective: The management of arteriovenous malformations (AVMs) remains challenging due to the high rate of recurrence of these lesions. Surgical resection is the only potential cure; however, it is often difficult to perform and carries a risk of massive hemorrhage. The purpose of this study was to review our experience with AVMs treated by surgical resection. Materials and Methods: We retrospectively reviewed the medical records of nine patients with AVM, treated with surgical resection. We treated these patients with excision surgery with or without embolotherapy. Results: Eight were treated with surgical resection with embolotherapy and one was treated with a simple surgical resection. Five patients with AVMs were cured. However, two cases of AVM recurred after total excision, and AVMs remained in two cases of partial excisional surgery in which the lesions involved the joints. Conclusions: Total excision of AVMs leads to a cure; however, total excision is not adequate in cases of AVMs involving the joints. Multidisciplinary treatment may offer good results in reducing the morbidity. To minimize complications related to surgery, aggressive control of blood flow to the lesion, preoperatively, with appropriate embolotherapy is essential, and a complete resection with a chance of cure will be increased.

Successful Complete Surgical Resection of a Large Venous Malformation of the Lower Extremity: A Case Report

“…For AVMs, arterial embolization is often used as the main treatment, and preoperative embolization can facilitate surgical resection by reducing intraoperative blood loss. 8 ) No obvious arteriovenous communications were identified in our patient. Therefore, we proceeded with surgical resection without the need for arterial embolization.…”

Surgical management of auricular arteriovenous malformations: A literature review

“…Even if the ipsilateral PAA, STA, OA, and external carotid artery (ECA) are ligated, the lesion can obtain blood supply from the vertebral artery, internal carotid artery, thyroid cervical trunk, or even the contralateral ECA 16,27 . Importantly, ligation methods may hinder subsequent endovascular treatment 7,30 . Thus, the current opinion is that simple proximal ligation should not be used to manage auricular AVMs 7,13,27,31,32 …”

“…16,27 Importantly, ligation methods may hinder subsequent endovascular treatment. 7,30 Thus, the current opinion is that simple proximal ligation should not be used to manage auricular AVMs. 7,13,27,31,32 3.4.2 | Surgical resection alone Surgical resection, either partial or total resection, is another common method for the treatment of auricular AVMs.…”

Case Report of Ethanol and Cyanoacrylate Embolisation of a Recurrent Uncontrollable Torrentially Bleeding Arteriovenous Malformation of the Finger

“…Ethanol ablation, however, commonly used in embolotherapy, has shown permanence in the management of AVM of the extremities and is effective for a large nidus in truncal, pelvic, and deep seated AVMs. 8 , 9 , 10 This therapy is rendered less effective following non-target embolisation.…”