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CardioVascular and Interventional Radiology
Published in: CardioVascular and Interventional Radiology 2/2014

01-04-2014 | Clinical Investigation

Ethanolamine oleate sclerotherapy combined with transarterial embolization using n-butyl cyanoacrylate for extracranial arteriovenous malformations

Authors: Akira Kitagawa, Yuichiro Izumi, Makiyo Hagihara, Seiji Kamei, Shuji Ikeda, Eisuke Katsuda, Junko Kimura, Toyohiro Ota, Tsuneo Ishiguchi

Published in: CardioVascular and Interventional Radiology | Issue 2/2014

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Abstract

Purpose

This study was designed to assess the safety and effectiveness of ethanolamine oleate (EO) sclerotherapy combined with transarterial embolization using a liquid adhesive agent (n-butyl cyanoacrylate, NBCA) for treatment of extracranial arteriovenous malformations (AVMs).

Methods

Twenty-four patients with symptomatic AVMs in the head and neck (n = 15), extremity (n = 5), and trunk (n = 4) with a mean age of 44 years (range, 18–78) treated with EO sclerotherapy were retrospectively assessed. AVMs were classified according to the angiographic morphology of the nidus. There were 7 type II (arteriolovenous fistulae), 6 type IIIa (arteriolovenulous fistulae with nondilated fistula), and 11 type IIIb (arteriolovenulous fistulae with dilated fistula). Transarterial embolization using NBCA was performed to reduce arterial flow before sclerotherapy. EO mixed with contrast material was delivered by percutaneous direct puncture or by catheterization into the draining vein under balloon occlusion.

Results

Three (13 %) of 24 patients were cured, 17 (71 %) had partial remission, and 4 (16 %) no remission. Treatment was considered effective (cure and partial remission) in 20 patients (83 %). Four patients (16 %) experienced transient minor complications, including self-healing skin ulcer (n = 3) and localized deep venous thrombosis (n = 1). There were no major complications.

Conclusions

EO sclerotherapy combined with transarterial embolization using NBCA is safe and effective for treating extracranial AVMs with an acceptable risk of minor complications.
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Metadata
Title
Ethanolamine oleate sclerotherapy combined with transarterial embolization using n-butyl cyanoacrylate for extracranial arteriovenous malformations
Authors
Akira Kitagawa
Yuichiro Izumi
Makiyo Hagihara
Seiji Kamei
Shuji Ikeda
Eisuke Katsuda
Junko Kimura
Toyohiro Ota
Tsuneo Ishiguchi
Publication date
01-04-2014
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 2/2014
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-013-0653-8

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