Treatment of head and facial arteriovenous malformation with ethanol embolization and surgical resection
10.3760/cma.j.cn1114453-20200305-00114
- VernacularTitle:头面部动静脉畸形的治疗：根治性无水乙醇介入与手术的综合运用
- Author:
Chen HUA
1
;
Yunbo JIN
;
Xi YANG
;
Yuanbo LI
;
Hechen JIA
;
Yun ZOU
;
Hui CHEN
;
Gang MA
;
Xiaoxi LIN
Author Information
1. 上海交通大学医学院附属第九人民医院整复外科血管瘤与脉管畸形中心 200011
- Keywords:
Arteriovenous malformation;
Absolute ethanol;
Embolization;
Surgical resection
- From:
Chinese Journal of Plastic Surgery
2020;36(4):361-367
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the treatment outcome of patients with head and facial arteriovenous malformation treated with absolute ethanol embolization alone, resection alone or combined ethanol embolization-resection.Methods:Medical records of 74 patients [41 male and 33 female; age mean, ( 29.1±10.6 )years]) with head and facial arteriovenous malformation between January of 2014 and December of 2018 were reviewed retrospectively. The most common sites were ear( n=25), cheek( n=20), and lip( n=18). Based on the pattern of lesion location and extent, a classified treatment strategy including ethanol alone, surgical resection and combined ethanol embolization-resection was established to gain satisfied treatment efficacy. Results:In total, cure was achieved in 50 patients (67.6%), and improvement was achieved in 24 patients. Ethanol embolization alone was performed in 42 patients [mean, ( 2.6±1.2) sessions]. The dosage of ethanol used per single session ranged from was 1.5 to 24.0 ml. Cure was achieved in 27 patients (64.3%), and improvement was achieved in 15 patients (35.7%). Surgical resection alone was performed in 15 patients. Cure was achieved in 12 patients (80.0%), and improvement was achieved in 2 patients (20%). Local flaps were performed in 2 patients, expanded flaps in 11 patients, and free flaps in 2 patients. Combined ethanol embolization-resection was performed in 17 patients. Cure was achieved in 11 patients (64.7%), and improvement was achieved in 6 patients (35.3%). In total, cure was achieved in 50 (67.6%) patients, improvement was achieved in 24 (32.4%) patients, with a follow-up of 27.0±11.3 months. A total of 2 major complications occurred in 2 patients. One patient experienced recurrence. Lesions involving ≥2 cervicofacial subunits had a lower cure rare compared with localized lesions ( P<0.05). Treatment outcomes were not significantly related to the treatment modalities ( P>0.05). Conclusions:Surgical resection and ethanol embolization, alone or combination, should be integrated in a regimen to treat head and facial arteriovenous malformation for gaining both satisfied treatment efficacy and optimal cosmetic outcome.
