RT Journal Article
SR Electronic
T1 Interventional management of high-flow craniofacial vascular malformations: a database analysis and review of the literature
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 92
OP 96
DO 10.1136/neurintsurg-2016-012315
VO 9
IS 1
A1 Dabus, Guilherme
A1 Linfante, Italo
A1 Benenati, James
A1 Perlyn, Chad A
A1 Martínez-Galdámez, Mario
YR 2017
UL http://jnis.bmj.com/content/9/1/92.abstract
AB Background High-flow craniofacial vascular malformations are uncommon, locally aggressive lesions that pose a therapeutic challenge.Objective To report our experience with the treatment of high-flow craniofacial vascular malformations.Methods After institutional review board approval was obtained, the neurointerventional databases of two institutions were retrospectively reviewed for vascular malformations from October 2010 to June 2015. All patients who had been treated for a high-flow craniofacial vascular malformation were included in the analysis. Clinical presentation, location, type, agent and techniques used, procedural complications, and clinical and imaging follow-up were included in the analysis.Results Eighteen patients (12 female and 6 male) harboring 21 high-flow vascular malformations met the inclusion criteria in our study. All patients were symptomatic. One patient had two separated arteriovenous malformations (AVMs) (one nasal and the other forehead/scalp), and one patient had three separated scalp lesions. One patient with a nasal AVM had capillary malformation-AVM syndrome. Overall, 13 AVM and 8 arteriovenous fistuli were treated in 31 targeted embolization procedures (ranging from 1 procedure to 4 procedures, mean 1.7 procedures). Onyx was the predominant agent used in 25 procedures. In 31 procedures, 1 procedural complication (skin ulceration) occurred. At the end of the last treatment session 14 of the 21 lesions were cured. Symptomatic control was achieved in all cases, with resolution or significant improvement of the symptoms (mean follow-up of 10 months).Conclusions High-flow craniofacial vascular malformations can be successfully managed with interventional techniques.