Therapeutic Embolization of Facial Arteriovenous Fistulae

Castañeda-Zúñiga, Wilfrido R.; Lehnert, Michael; Nath, P. H.; Zollikofer, Christoph L.; Velasquez, Guillermo; Amplatz, Kurt

doi:10.1148/132.3.599

Cited by 24 publications

(7 citation statements)

References 4 publications

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“…Em-bolization decreases operative blood loss and the size of the AVM and, in some cases, may decrease the extent of surgical excision required. 12,13 In our case, preoperative embolization decreased the vascularity of the AVM but did not significantly alter the extent of resection.…”

Section: Discussionmentioning

confidence: 47%

“…10,11 In addition, embolization poses a risk of deposition of stray particles into normal territories, including the internal carotid system. 3,12 Based on experience with embolization of cerebral AVMs, the number, size, and shape of the feeding vessels must be taken into consideration to prevent compromise of normal tissue territories during embolization.…”

Section: Discussionmentioning

confidence: 99%

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Arteriovenous malformation of the base of tongue: Case report and literature review

et al. 1996

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Arteriovenous malformations of the head and neck pose a challenging therapeutic and reconstructive problem. In this report we describe a rare case of an arteriovenous malformation of the base of tongue. The patient, a young adult female, was treated with embolization followed by surgical resection using a lateral pharyngotomy approach. Reconstruction of the extensive base of tongue defect was accomplished using a radial forearm free flap. Currently, the patient is decannulated, articulates clearly, tolerates a normal diet, and is without recurrence. Our treatment approach is discussed in detail and compared with alternative techniques.© 1998 Wiley-Liss, Inc. MICROSURGERY 17:706-709 1996Arteriovenous malformation (AVM) of the external carotid artery is a vascular lesion rarely encountered in clinical practice. Histologically, an AVM consists of thick-walled, dysmorphic arteries with aberrant venous connections. Secondary changes within the veins include progressive reactive hypertrophy, intimal thickening, and sclerosis. AVMs of the external carotid artery typically present in late childhood or early adulthood. Symptoms can include throbbing pain, a ''buzzing'' sound in the ear, or pulsatile tinnitus, depending on the location of the lesion.2,3 On physical examination, an AVM appears as an erythematous blush of the skin or mucosa that is warm to the touch. Arteriovenous shunting is suggested by the presence of a bruit on auscultation or Doppler examination. Infection, trauma, or hormonal changes can cause rapid expansion and bleeding in a previously stable AVM.Magnetic resonance imaging (MRI) is the preferred radiologic study for displaying the involved tissue planes and the flow characteristics of this lesion. In addition, angiography with selective embolization is usually performed prior to surgical resection to decrease the vascularity of the lesion and to define precisely the feeder vessels. Embolization followed by complete surgical resection provides the best chance for long-term cure. Incomplete surgical excision of the anomalous vascular channels invariably leads to further collateralization, shunting, expansion, and ultimately clinical recurrence. 4 In the present report we describe a rare case of an AVM of the tongue base. The patient was treated with embolization followed by complete surgical resection. Reconstruction was accomplished using a radial forearm free flap. The short-and long-term advantages of our treatment approach for this rare problem are discussed. CASE REPORTA 34-year-old white female presented to her local emergency room with hematemesis and epigastric pain. She had been previously diagnosed with peptic ulcer disease, based on a single episode of hematemesis. On physical examination, the patient was pale and tachycardic. A complete blood count revealed a hemoglobin of 7.9. The patient was fluidresuscitated using packed red blood cells. Emergent upper endoscopy revealed no identifiable bleeding source. An otolaryngology consultation was obtained and on oropharyngeal examination, a large...

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Arteriovenous malformation of the base of tongue: Case report and literature review

et al. 1996

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“…However, there is some evidence that recanalization can occur as many as 2 years from the date of embolization and thus surgical resection or radiosurgery should follow endovascular therapy [9, 10]. The use of PVA to embolize vascular lesions of the head and neck supplied by branches of the external carotid artery has also been reported [5, 6]. In a similar case, a facial hemangioma in a 2-month-old child causing life threatening consumptive coagulopathy as well as airway compromise and cranial nerve deficits was successfully obliterated with PVA embolization of the facial, posterior auricular and superficial temporal arteries [7].…”

Section: Discussionmentioning

confidence: 99%

“…This technique can be applied to the intracranial circulation to reduce the size of cerebral arteriovenous malformations (AVMs) making these lesions amenable to safer surgical resection or radiosurgery [1, 2, 3, 4]. There are also reports of using particles and liquids via the extracranial circulation to treat hemangiomas, arteriovenous fistulas, and neoplasms [5, 6]. A more recent report demonstrates the use of particles for a cervicofacial hemangioma complicated by thrombocytopenia and a consumptive coagulopathy (Kasabach-Merritt Syndrome) [7].…”

Section: Introductionmentioning

confidence: 99%

Endovascular Particulate and Alcohol Embolization for Near-Fatal Epistaxis from a Skull Base Vascular Malformation

Koebbe

Horowitz²,

Levy³

et al. 2001

Pediatr Neurosurg

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A three-year old girl who initially presented at 16 months with epistaxis from an anterior skull base vascular anomaly returned with near-fatal epistaxis despite embolization of the internal maxillary artery at the time of initial presentation. Repeat angiography demonstrated blood supply to the vascular lesion coming from branches of both the external and internal carotid arteries. The patient underwent four sessions of endovascular embolization with polyvinyl alcohol, alcohol, and gelatin microspheres. At the conclusion of treatment, her epistaxis had resolved and the only residual blood supply to the lesions came from bilateral ophthalmic arteries intentionally not sacrificed to prevent loss of vision. Endovascular embolization of both the internal and external carotid arteries is a challenging but important treatment option for life-threatening epistaxis resulting from vascular lesions of the skull base.

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“…Gelatin sponges and polyvinyl alcohol particles have been among the most popular particulate embolie agents used to address hypervascular tumors, arterial bleeding, and vascular malformations (1)(2)(3)(4)(5). Calibrated microspheres are now widely employed especially for the embolization of uterine fibroids (6,7) and drug-eludng microspheres are injected for liver tumor embolization (8,9).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the embolic effect and degradability of gelatin microspheres and gelpart particles

Nitta

Ohta

Sonoda

et al. 2012

Minimally Invasive Therapy & Allied Technologies

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Therapeutic Embolization of Facial Arteriovenous Fistulae

Cited by 24 publications

References 4 publications

Arteriovenous malformation of the base of tongue: Case report and literature review

Arteriovenous malformation of the base of tongue: Case report and literature review

Endovascular Particulate and Alcohol Embolization for Near-Fatal Epistaxis from a Skull Base Vascular Malformation

Evaluation of the embolic effect and degradability of gelatin microspheres and gelpart particles

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