Percataneous radio frequency ablation for complicated diffuse arteriovenous malformations: a report of 12 cases
10.3760/cma.j.issn.1009-4598.2018.05.005
- VernacularTitle: 经皮射频消融术治疗复杂弥漫性动静脉畸形12例
- Author:
Maozhong TAI
1
;
Chunxiao GE
;
Kelei LI
;
Xuejian LIU
;
Tao CHEN
;
Zhongping QIN
Author Information
1. Special Department of Hemangiomas, Linyi Tumor Hospital, Linyi 276001, China
- Publication Type:Clinical Trail
- Keywords:
Arteriovenous malformation;
Radio frequency ablation
- From:
Chinese Journal of Plastic Surgery
2018;34(5):347-353
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and feasibility of radiofrequency ablation(RFA) for complicated diffuse arteriovenous malformations.
Methods:From Dec. 2014 to Dec. 2016, 12 cases with complicated diffuse arterioveneous malformations were treated by RFA in our hospital. The clinical records were retrospectively reviewed. The lesion size ranged from 10 cm×7 cm to 28 cm×30 cm. Ablation procedures with " high power and long time" technique were performed under real time color Doppler monitoring. The impedance model were used and ablation needles were punctured into core lesions with the most abundant blood flow. Power was set as 90 to 110 W for central core lesions, and 60 to 80 W for superficial or surrounding lesions. The average ablation time was from 60 to 90 min (average, 75 min). Next treatment would be performed 3 months later when neccessary. The therapeutic efficacy was evaluated on a 4-level scale.
Results:Hyperpyrexia occurred in 1 patients during first and second treatments. Transient postoperative hemoglobinuria occurred in 2 patient. Full thickness defects induced by tissue necrosis in the original ulcer area of cheek occurred in 1 patient, which was reconstructed with pedicle Trapezius muscle myocutaneous flap. Bleeding symptom in 7 cases stopped after only 1 treatment. After a follow-up period of 1-3 years, the efficacy was graded as Ⅳ in 8 case, as Ⅲ in 4 cases.
Conclusions:For complicated diffuse arteriovenous malformations, radio frequency ablation with "high power and long time" technique under real time color Doppler monitoring can completely damage the deep core soft lesions, and control the life-threatening hemorrhage effectively, which can be recommended as the alternative therapy when surgery, interventional embolizationor or sclerosant injection can not control the lesions.
