Wohlgemuth, Walter A. and Mueller-Wille, Rene and Teusch, Veronika I. and Dudeck, Oliver and Cahill, Anne M. and Alomari, Ahmad I. and Uller, Wibke (2015) The Retrograde Transvenous Push-Through Method: A Novel Treatment of Peripheral Arteriovenous Malformations with Dominant Venous Outflow. CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 38 (3). pp. 623-631. ISSN 0174-1551, 1432-086X
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To evaluate the efficacy and safety of a novel retrograde transvenous embolization technique of peripheral arteriovenous malformations (AVMs) using Onyx. We conducted a retrospective analysis of all patients who underwent transvenous retrograde Onyx embolization of peripheral AVMs with dominant venous outflow over a 29-month period. The embolization is aimed at retrograde filling of the nidus after building a solid plug in the dominant venous outflow (push-through). Classification, clinical signs, technical aspects, clinical and technical success rates, and complications were recorded. Short-term outcome was assessed. 11 Symptomatic patients (8 female; mean age 31.4 years) were treated at our Vascular Anomalies Center with this method between January 2012 and May 2014. The AVMs were located on the upper extremity (n = 3), pelvis (n = 2), buttock (n = 2), and lower extremity (n = 4). Retrograde embolization was successfully carried out after preparatory transarterial-flow reduction in eight cases (73 %) and venous-flow reduction with Amplatzer Vascular Plugs in four cases (36 %). Complete devascularization (n = 10; 91 %) or 95 % devascularization (n = 1; 9 %) led to complete resolution (n = 8; 73 %) or improvement of clinical symptoms (n = 3; 27 %). One minor complication occurred (pain and swelling). During a mean follow-up time of 8 months, one clinically asymptomatic recurrence of AVM was detected. Initial results suggest that retrograde transvenous Onyx embolization of peripheral AVMs with dominant venous outflow is a safe and effective novel technique with a low complication rate.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | ALCOHOL COPOLYMER ONYX; VASCULAR MALFORMATIONS; ENDOVASCULAR TREATMENT; ETHANOL EMBOLIZATION; VEIN; Venous intervention; Embolization/embolization/embolotherapy; Vascular malformations; Arteriovenous |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Röntgendiagnostik |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 15 Jul 2019 07:38 |
| Last Modified: | 15 Jul 2019 07:38 |
| URI: | https://pred.uni-regensburg.de/id/eprint/5464 |
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