Arteriovenous malformations of the head and neck: current concepts in management

Fowell, C.; Jones, Robert G.; Nishikawa, Hiroshi; Monaghan, Andrew

doi:10.1016/j.bjoms.2016.01.034

Cited by 30 publications

(28 citation statements)

References 34 publications

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“…Depending on the vessels involved and flow characteristics, they are divided in venous (VM 70%), lymphatic (LM 15%), arterio-venous (AVM 6%) and capillary (CM 9%) malformations with slow-flow (VM, LM, CM) or fast-flow properties (AVM) [16], [17], [18]. Vascular anomalies progress with patient’s age, never regress and require treatment when symptomatic.…”

Section: Resultsmentioning

confidence: 99%

Interdisciplinary Management of Head and Neck Vascular Anomalies: Clinical Presentation, Diagnostic Findings and Minimalinvasive Therapies

Sadick

Wohlgemuth

Huelse

et al. 2017

European Journal of Radiology Open

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ObjectivesVascular anomalies are included in the 30 000 rare diseases worldwide affecting less than 5/10 000 people. Depending on their morphology and biological properties, they can cause varied disorders with organ involvement. Almost 60% of vascular anomalies have a predilection for the head and neck region in children. Clinical and scientific effort to establish interdisciplinary management concepts for vascular anomalies is increasing worldwide.MethodsEspecially in the head and neck region, clinical impairment and organ dysfunction is associated with cosmetic issues that may represent a physical and psychological issue for the patient. Correct diagnosis, based on clinical presentation and symptoms, is a prerequisite for appropriate therapy, ranging from conservative management to a spectrum of minimally invasive treatment options. We searched PubMed for German and English language published data until December 2016 with focus on clinical studies, review articles and case reports on vascular anomalies with a focus on the head and neck region.ResultsThe last ISSVA update in 2014 has contributed to a better understanding of vascular anomalies, classifying them in vascular tumors and vascular malformations. The predominant representatives of vascular tumors are congenital and infantile hemangiomas. Infantile hemangiomas have the ability of spontaneous regression in more than 80%. Patients with symptomatic growing hemangiomas with ulcerations, bleeding complications and restriction of hearing, swallowing disorder, impairment of vision, or cosmetic dysfigurement require treatment. Therapies include oral propanolol, transcatheter embolization and surgery. Vascular malformations tend to progress with patientś age and are subdivided in slow flow and fast flow lesions. Symptomatic slow flow lesions, e.g. venous and lymphatic malformations, benefit from percutaneous sclerotherapy. Fast flow lesions, as arteriovenous malformations, are rare but undoubtedly therapeutically the most challenging vascular anomaly. Depending on location and size, they may require multiple transcatheter embolization procedures for successful occlusion of the AVM.ConclusionsThis review provides knowledge on the current ISSVA classification of vascular anomalies, their clinical presentation, diagnostic evaluation and minimally invasive therapy options to encourage the establishment of a comprehensive interdisciplinary management for head and neck vascular anomalies.

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Section: Resultsmentioning

confidence: 99%

Interdisciplinary Management of Head and Neck Vascular Anomalies: Clinical Presentation, Diagnostic Findings and Minimalinvasive Therapies

Sadick

Wohlgemuth

Huelse

et al. 2017

European Journal of Radiology Open

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“…4,7 Given the potential side effects of treatment, interventional management for AVMs is often reserved for progressive lesions of Schobinger Stage II and above. 1 Resection within 24-48 hours of embolization is ideal for delineating lesions and preventing acute inflammation caused by embolic materials. 14 The final embolization procedure was performed within 24 hours of complete AVM resection.…”

Section: Discussionmentioning

confidence: 99%

“…Combined embolization and resection represents the "first-line" therapy for many AVMs. 1 In this report, we describe the case of a large and complex extradural, parietooccipital intraosseous cranial AVM that was treated using a combination of embolization and surgery.…”

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confidence: 99%

The rare case of a large complex intraosseous cranial arteriovenous malformation with successful multidisciplinary management

Al-Smadi¹,

Shokuhfar²,

Johnston³

et al. 2017

Journal of Neurosurgery: Pediatrics

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Intraosseous cranial arteriovenous malformations (AVMs) are very rare, challenging entities. The authors report the case of an extracranial parietooccipital vascular lesion. A 12-year-old boy presented with accelerated growth of a right scalp lesion over a few months. Digital subtraction angiography showed a large, right parietooccipital intraosseous AVM with multiple complex arterial feeders. Treatment of these lesions is difficult and can necessitate a multidisciplinary approach. In the featured case, 6 embolization procedures were performed over 1 year, including both transarterial and transvenous approaches, followed by total resection. The authors describe what is thought to be the second case of an AVM originating in the cranial bones and the first case with successful multidisciplinary management.

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“…En otros casos, se apuesta por realizar embolización de la carótida externa previa a la cirugía, para así disminuir el flujo sanguíneo antes de la resección quirúrgica. La embolización sola, de todos los vasos nutrientes de la fístula no es efectiva, ya que parte de la lesión es hemodinámicamente inactiva e inaccesible a los émbolos, quedando áreas residuales, que debido a la hipoxia y al aumento de factores de crecimiento, llevan a la recurrencia 3,4 . Se han descrito varias técnicas de embolización, con etanol, coils, n-BCA, Onyx, pero no hay consenso sobre cuál es la mejor, ya que todas tienen sus riesgos y complicaciones 5,6 .…”

Section: Discussionunclassified

“…Se han descrito varias técnicas de embolización, con etanol, coils, n-BCA, Onyx, pero no hay consenso sobre cuál es la mejor, ya que todas tienen sus riesgos y complicaciones 5,6 . Se sabe que el control de las lesiones es mejor cuando el material consigue penetrar y obliterar el nido de vasos (la zona central), por eso nuevos materiales se están investigando, aunque tienen el riesgo de viajar a zonas distantes y producir isquemia 4,7 . El etanol es un material esclerosante que ha demostrado, en algunos casos, ablación permanente de lesiones arteriovenosas sin necesidad de tratamientos posteriores, pero éste no funciona en todas las malformaciones A-V, sobre todo en las que tienen una vena dominante con flujo de salida 8 , como en nuestro caso; además, las complicaciones que pueden surgir de su uso son graves, como son la necrosis y el colapso cardiopulmonar 9 .…”

Section: Discussionunclassified

Malformación arteriovenosa en cavidad oral: A propósito de un caso y revisión de la literatura

et al. 2017

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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Arteriovenous malformations of the head and neck: current concepts in management

Cited by 30 publications

References 34 publications

Interdisciplinary Management of Head and Neck Vascular Anomalies: Clinical Presentation, Diagnostic Findings and Minimalinvasive Therapies

Interdisciplinary Management of Head and Neck Vascular Anomalies: Clinical Presentation, Diagnostic Findings and Minimalinvasive Therapies

The rare case of a large complex intraosseous cranial arteriovenous malformation with successful multidisciplinary management

Malformación arteriovenosa en cavidad oral: A propósito de un caso y revisión de la literatura

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