Head and Neck Arteriovenous Malformations: Clinical Manifestations and Endovascular Treatments

Abstract

Arteriovenous malformations (AVMs) are vascular malformations that present high-flow direct communication between the arteries and veins, not involving the capillary beds. They can be progressive and lead to various manifestations, including abnormal skin or mucosal findings, ischemia, hemorrhage, and high-output heart failure in severe cases. AVMs often involve the head and neck region. Head and neck AVMs can present region-specific clinical manifestations, angioarchitecture, and complications, especially in cosmetic appearance and ingestion, respiratory, and neuronal functions. Therefore, when planning endovascular treatment of head and neck AVMs, physicians should consider not only the treatment strategy but also the preservation of the cosmetic appearance and critical functions. Knowledge of the functional vascular anatomy as well as treatment techniques should facilitate a successful management. This review summarizes AVMs' clinical manifestations, imaging findings, treatment strategy, and complications.

Interdisziplinäres Management vaskulärer Anomalien im Kopf-Hals-Bereich

“…Wie auch bei anderen Malformationen, stellen der Kopf-Hals-Bereich und das Gesicht eine besondere Herausforderung bei der Behandlung arteriovenöser Malformationen dar, da es rasch zu einer funktionellen und ästhetischen Beeinträchtigung kommt. Die komplexe Gefäßanatomie erschwert zudem die Therapie 98 . Es gibt eine Reihe von symptomorientierten Klassifikationen der arteriovenösen Malformationen.…”

“…As with other malformations, the head and neck region and the face pose a particular challenge in the treatment of arteriovenous malformations, as functional and esthetic impairment quickly occurs. The complex vascular anatomy also makes treatment more difficult 98 . There are a number of symptom-oriented classifications of arteriovenous malformations.…”

“…In most cases, endovascular treatment is therefore recommended as primary therapy. Possible procedures include endovascular and/or percutaneous techniques 85 98 . Complete embolization of the entire vascular architecture should be aimed for.…”

“…In den meisten Fällen empfiehlt sich daher eine endovaskuläre Behandlung als Primärtherapie. Mögliche Verfahren sind endovaskuläre und/oder perkutane Techniken 85 98 . Es sollte eine vollständige Embolisation der gesamten Gefäßarchitektur angestrebt werden.…”

Influence of transcatheter arterial embolization on symptom distress and fatigue in liver cancer patients

“…Nonetheless, following TAE, hepatocytes incur variable degrees of damage, leading to the development of a constellation of symptoms reminiscent of acute hepatitis. These symptoms include fatigue and systemic discomfort, such as nausea, vomiting, fever, abdominal pain, as well as transient elevations in aspartate aminotransferase (AST) and alanine aminotransferase (ALT), collectively referred to as postembolization syndrome[ 3 , 4 ]. These symptoms may arise due to ischemia of the liver and gallbladder, temporary liver enlargement, and peritoneal irritation.…”