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E-078 Endovascular Vein Approach and Direct Puncture Retrograde Vein Approach for Curative AVM Treatment: A New Unreported Technique
  1. W Yakes
  1. Vascular Malformation Center, Englewood, CO


Purpose To evaluate the role of Retrograde Vein and Direct Puncture Retrograde Vein Endovascular Repair of Large Peripheral AVMs.

Materials and methods Eighty-seven patients (45 males, 42 females; age: 14–72, mean age: 27 years) presented for repair of AVMs involving head and neck, shoulder, chest wall, intra-thoracic, abdominal, renal, pelvic, buttock, and extremities. Ethanol and ethanol/coils were the embolic agents used. Retrograde transvenous catheterizations and vein direct puncture retrograde vein approaches were used in all patients.

Results Eighty-five of 87 patients are cured at long-term follow-up (f/up: 14 months to 138 months; mean: 42 months) and 2 patients’ therapy is on-going. Complications include 1 pelvic AVM post-Rx small bleed not requiring transfusion; 1 pelvic AVM coils eroded into bladder wall removed uneventfully via trans-urethra endoscopy; 2 infections treated with antibiotics; 2 patients’ coils superficially eroded and uneventfully removed; and 1 patient subcutaneous hematoma removed (7/87 patients; 8% minor complications).

Conclusions Retrograde vein and direct puncture vein access and embolization of AVMs in many anatomic locations have proven curative at long-term f/up of AVMs in multiple anatomic locations with a low complication rate. Reproducible and consistent results of this technique have been reported by Yakes (1990) et al, Jackson (1996) et al and Cho (2008), et al.

Disclosures W. Yakes: None.

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