Nonsurgical treatment of scalp arteriovenous malformation using a combination of ultrasound-guided thrombin injection and transarterial coil embolization

Abstract

Scalp arteriovenous malformations are treated by surgical excision in many patients. We report a patient with a scalp arteriovenous malformation who was successfully treated by a combination of ultrasound-guided thrombin injection (UGTI) and transarterial coil embolization. This patient was a 52-year-old man with a subcutaneous mass in the left retroauricular region. An angiogram showed that the mass was a nidus of arteriovenous malformation. We performed UGTI after transarterial coil embolization. No recurrence or complication was reported during 2 years of follow-up. This report describes the advantages of UGTI and the method for complete occlusion of the collateral artery.

Surgical management of scalp arteriovenous malformations using a novel surgical technique—Case series

“…Treatment options include surgical excision [1], [2], [4], trans arterial and trans venous embolization [5] and intranidal injection of sclerosant [6]. Surgical excision is the most common and successful method of dealing with SAVMs [1], [3], [4], [5], [6].…”

“…Surgical excision is the most common and successful method of dealing with SAVMs [1], [3], [4], [5], [6]. Various techniques have been used to control hemorrhage during surgery like percutaneous suture of feeding vessels and interlocking suture along line of incision [2].…”

“…Various techniques have been used to control hemorrhage during surgery like percutaneous suture of feeding vessels and interlocking suture along line of incision [2]. Preoperative embolization has been advocated by some to reduce intraoperative blood loss [4], [5]. We have used temporary occlusion of the main feeding artery to decrease the vascularity of the lesion.…”

“…All this reflected in the reduced treatment cost of these patients. This method also obviates the chances of recurrence which is seen in endovascular embolization when used as a standalone treatment technique for these lesions [4], [5], [6]. This novel technique of temporary arterial occlusion has not been reported in literature to the best of our knowledge.…”

“…A progressive growing pulsatile mass,bruit and a throbbing headache are the usual complaints of the patient [2]. Treatment options of SAVMs include surgical excision, trans-arterial or trans-venous embolization and injection of sclerosants into nidus[1], [2], [4], [5], [6]. However, only total surgical excision offers a cure to these lesions.…”