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DOI: 10.1055/s-0044-1791187
High-Flow Arteriovenous Malformations: Treatment Using a Venous Approach
Abstract
High-flow arteriovenous malformations (AVMs) are among the rarest and most recalcitrant lesions in medicine. Patients with these anomalies are best managed longitudinally in tertiary referral centers by dedicated multidisciplinary teams that include surgeons, dermatologists, hematologists, geneticists, and interventional radiologists. A significant percentage of these lesions cannot be cured per se and intervention can worsen symptoms or preclude effective future embolization. Existing classification systems help guide treatment, but in nearly all cases, therapy must be individualized based on patient, symptoms, and lesion angioarchitecture. For various reasons, referral to tertiary centers may be impossible for some patients. The purpose of this article is to provide an approach to the evaluation and treatment of these abnormalities.
Publication History
Article published online:
07 November 2024
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References
- 1 Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: clinical application of a new classification. J Pediatr Surg 1983; 18 (06) 894-900
- 2 Yakes WF, Vogelzang RL, Ivancev K, Yakes AM. New arteriographic classification of AVM based on the Yakes classification system. In: Kim YW, Lee BB, Yakes W, Do YS. , eds., Congenital Vascular Malformations. Berlin:: Springer; 2017: 63-69
- 3 Kim R, Do YS, Park KB. How to treat peripheral arteriovenous malformations. Korean J Radiol 2021; 22 (04) 568-576
- 4 Park KB, Do YS, Kim DI. et al. Endovascular treatment results and risk factors for complications of body and extremity arteriovenous malformations. J Vasc Surg 2019; 69 (04) 1207-1218
- 5 Bouwman FCM, Botden SMBI, Verhoeven BH. et al. Treatment outcomes of embolization for peripheral arteriovenous malformations. J Vasc Interv Radiol 2020; 31 (11) 1801-1809
- 6 Brill RM, Guntau M, Wildgruber M. et al. Safety and effectiveness of ethylene vinyl alcohol copolymer embolization of peripheral high-flow arteriovenous malformations: results of a prospective study. J Vasc Interv Radiol 2021; 32 (12) 1644-1653.e1
- 7 Giurazza F, Corvino F, Cangiano G. et al. Transarterial embolization of peripheral high-flow arteriovenous malformation with ethylene vinyl alcohol copolymer (Onyx®): single-center 10-year experience. Radiol Med 2019; 124 (02) 154-162
- 8 Gomes AS. Embolization therapy of congenital arteriovenous malformations: use of alternate approaches. Radiology 1994; 190 (01) 191-198
- 9 Jackson JE, Mansfield AO, Allison DJ. Treatment of high-flow vascular malformations by venous embolization aided by flow occlusion techniques. Cardiovasc Intervent Radiol 1996; 19 (05) 323-328
- 10 Cho SK, Do YS, Kim DI. et al. Peripheral arteriovenous malformations with a dominant outflow vein: results of ethanol embolization. Korean J Radiol 2008; 9 (03) 258-267
- 11 Conway AM, Qato K, Drury J, Rosen RJ. Embolization techniques for high-flow arteriovenous malformations with a dominant outflow vein. J Vasc Surg Venous Lymphat Disord 2015; 3 (02) 178-183
- 12 Wohlgemuth WA, Müller-Wille R, Teusch VI. et al. The retrograde transvenous push-through method: a novel treatment of peripheral arteriovenous malformations with dominant venous outflow. Cardiovasc Intervent Radiol 2015; 38 (03) 623-631
- 13 van der Linden E, van Baalen JM, Pattynama PM. Retrograde transvenous ethanol embolization of high-flow peripheral arteriovenous malformations. Cardiovasc Intervent Radiol 2012; 35 (04) 820-825