Effect of interventional embolization based on absolute ethanol for peripheral arteriovenous malformations.

BACKGROUND: Interventional embolization schedules based on absolute ethanol are usually used for peripheral arteriovenous malformations (PAVMs), and clinicians often choose the scheme according to the classification. AIM: To evaluate different interventional embolization schedules based on absolute ethanol for PAVMs. METHODS: A retrospective study was performed of 165 patients with PAVMs treated with interventional embolization based on absolute ethanol in Henan Provincial People's Hospital from January 2018 to May 2021. PAVMs were classified as type II (n = 67), type III (n = 81) and type IV (n = 17) according to the Yakes classification system, including 123 maxillofacial, 13 trunk and 29 limbs. Effectiveness of embolization was based on PAVM devascularization on angiography: 100% (total), 90%~99% (near-total), 70%~90% (substantial), 30%~70% (partial) and 0%~30% (failure). RESULTS: PAVMs were classified as type II (n = 67), type III (n = 81) and type IV (n = 17) according to the Yakes classification system, including 123 maxillofacial (74.55%), 13 trunk (7.88%) and 29 limbs (17.58%). There are statistical differences in the angiographic outcomes among different Yakes classification and between different methods (P < 0.05), and there was a statistical difference in the failure rates among different Yakes classification (P < 0.05). CONCLUSIONS: PAVMs occur maxillofacial usually, and Type II can achieve better effect by spring coil and absolute ethanol, while Type III and Type IV have no ideal effect by Pingyangmycin + iodized oil + PVA + absolute ethanol and spring coil + absolute ethanol, respectively. Both the two happen to be complications, and wound accounts the highest.

Peripheral Arteriovenous Malformations-A Case Series.

CONTEXT: Arteriovenous malformations (AVMs) are aggressive vascular malformations that often result in significant morbidity. Patients may present to a dermatologist due to associated skin changes. Early diagnosis is important as treatment is available to halt their progression toward irreversible destruction of adjacent tissues. AIMS: To study the clinical profile of peripheral AVMs presenting to the dermatologist and to provide a diagnostic algorithm. SETTINGS AND DESIGN: A retrospective study of patients of all age groups with peripheral AVMs who presented to the Department of Dermatology at a tertiary care hospital in India was performed. Syndromic forms were also included. SUBJECTS AND METHODS: We conducted a search of patients with peripheral AVMs, which were seen over a period of 51 months, i.e., from July 2014 to September 2018, from electronic medical records and reviewed their clinical details. STATISTICAL ANALYSIS USED: Descriptive statistics such as frequency, mean, and median were computed. RESULTS: We report a series of 13 patients with peripheral AVMs, which constituted 6.7% (13/193) of all vascular malformations during this period. Of these, 8.3% (1/12) belonged to Schobinger's stage 1, 41.7% (5/12) to stage 2, 50% (6/12) to stage 3, and one with subcutaneous involvement devoid of cutaneous changes. The most common location was the extremities, which was seen in 53.8% (7/13). Syndromic association was present in 46.2% (6/13). Management included embolization, surgery, and medical treatment. CONCLUSIONS: The proportion of peripheral AVMs out of all vascular malformations was similar to reported studies. The extremities were more frequently involved as compared to the head and neck. The diagnostic algorithm provided will help us to optimize investigations and direct early management.