Endovascular management of a pelvic arteriovenous malformation

Cleary, Colin; Masood, Maleek; Boutrous, Mina L.; Amankwah, Kwame S.

doi:10.1016/j.jvscit.2022.10.008

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Pelvic AVMs are rare and reported to affect less than 1 % of the general population with a female predominance [ 5 ]. They are a rare cause of PR bleeding compared to diverticular disease or haemorrhoids.…”

Section: Discussionmentioning

confidence: 99%

Pelvic arteriovenous malformation causing per rectal haemorrhage – A case report

Gao,

Lodh,

Ahmadi

2024

International Journal of Surgery Case Reports

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Section: Discussionmentioning

confidence: 99%

Pelvic arteriovenous malformation causing per rectal haemorrhage – A case report

Gao,

Lodh,

Ahmadi

2024

International Journal of Surgery Case Reports

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“…Ligation of the arterial origin of the AVM is not advised because this procedure leads to the nidus promoting additional recruitment of feeding vessels from the arterial tree, often making the disease even more complex. Percutaneous embolization with small particles and glue has gained traction as treatment modalities, 2 , 3 however, depending on the size of the AVM, cure is impractical. In these cases, the focus should be directed toward treating the consequences of the AVM that are most dire and requiring of focus.…”

mentioning

confidence: 99%

Complex gastrointestinal vascular malformation treated with interpositional mesocaval shunt (Drapanas procedure)

Neves¹,

Moreira²,

Akahane³

et al. 2023

Journal of Vascular Surgery Cases, Innovations and Techniques

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Pelvic AVM Embolization: A Tricky Affair—Multicenter Retrospective Experience

Szmygin,

Giurazza,

Marini

et al. 2024

J Endovasc Ther

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Purpose: Pelvic arteriovenous malformations (pAVMs) are congenital or acquired vascular anomalies, presenting with hematuria, menometrorrhagia, pelvic pain, and varices; they can be life-threatening in case of rupture. Surgical therapies have been proposed but endovascular embolization has been recognized as the primary modality. The aim of this article was to report a retrospective multicenter experience concerning embolization of pelvic AVMs and provide literature overview. Materials and Methods: We describe 18 patients (14 female and 4 male) diagnosed with pAVM and treated with minimally invasive methods. The pre-procedural imaging evaluation was based on transpelvic and/or transvaginal color Doppler ultrasound, contrast-enhanced computed tomography, and/or magnetic resonance. In 3 cases, the malformation was congenital and in other 15, acquired. Most common symptoms were menometrorrhagia, hematuria, pelvic pain and pressure, and heaviness in the lower abdominal region. In 10 cases (56%), only 1 procedure was required. Eight patients underwent multistage treatment. Results: Complete occlusion of the lesion in post-procedural angiography was observed in 12 patients (67%). No major periprocedural complications were observed. In 14 cases (78%), both satisfactory embolization and significant clinical improvement was achieved in long-term follow-up. Sixteen patients (88%) were at least satisfied with the clinical outcome. One patient reported subsequent successful pregnancy 5 years after the treatment. Conclusion: Hemodynamics of pAVM are variable and thorough understanding of the vessel anatomy is crucial in planning and choosing proper treatment. Both transarterial and percutaneous direct puncture embolization strategies appear safe, technically feasible, and clinically effective. Clinical Impact In this manuscript, we discuss the role of interventional radiology methods in the treatment of pelvic arteriovenous malformations along with its advantages, limitations and possible complications. In addition to this, we review the current literature and confront our findings with those made by other authors. We believe that modern endovascular methods offer safe and reliable alternative for traditional surgical therapy and should be therefore considered during multidisciplinary treatment of these patients.

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Endovascular management of a pelvic arteriovenous malformation

Cited by 4 publications

References 14 publications

Pelvic arteriovenous malformation causing per rectal haemorrhage – A case report

Pelvic arteriovenous malformation causing per rectal haemorrhage – A case report

Complex gastrointestinal vascular malformation treated with interpositional mesocaval shunt (Drapanas procedure)

Pelvic AVM Embolization: A Tricky Affair—Multicenter Retrospective Experience

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