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Published in: BMC Cardiovascular Disorders 1/2021

Open Access 01-12-2021 | Sclerotherapy | Research article

Analysis of 18 complex diffuse arteriovenous malformation cases treated with percutaneous radiofrequency ablation

Authors: Chun-Xiao Ge, Mao-Zhong Tai, Tao Chen, Ke-Lei Li, Zhen-Guo Xu, Zhong-Ping Qin

Published in: BMC Cardiovascular Disorders | Issue 1/2021

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Abstract

Background

The aim of the present study is to evaluate the short-term efficacy and feasibility of radiofrequency ablation in the treatment of complex diffuse arteriovenous (AV) malformations.

Methods

The data of 18 patients (8 male and 10 female) with complex AV malformations treated between December 2014 and June 2019 were analyzed retrospectively. The lesion area was 10 × 7 cm ~ 28 × 30 cm. Under duplex ultrasound guidance, the site with the most abundant blood flow signals in the lesion was percutaneously punctured with the radiofrequency ablation needle (electrode). The impedance automatic adjustment mode was adopted, and ablation was monitored usingduplex ultrasoundduring the entire process.

Results

Of the included patients, 1 had a high fever after two rounds of treatment, 2 had transient hemoglobinuria, and 1 had tissue necrosis in the original ruptured tumor area as well as a penetrating defect in the cheek, which was repaired with a pedicled trapezius myocutaneous flap. In 9 patients who experienced bleeding, the bleeding stopped after one round of treatment. During the follow-up period of 1–5 years, there were 0 grade I (poor) cases, 0 grade II (medium) cases, 7 grade III (good) cases, and 11 grade IV (excellent) cases.

Conclusion

The “high power and continuous” radiofrequency ablation technique conducted under real-time duplex ultrasoundmonitoring can completely destroy the deep core lesions of AV malformations and effectively control life-threatening massive hemorrhage; it is an effective alternative treatment method for complex diffuse AV malformations in which interventional embolization, sclerotherapy, and surgery are ineffective.
Literature
1.
go back to reference Shah K, Srinivasan B, Ethunandan M, Pratt C. Arteriovenous malformation of the jaws: a black hole for the GDP—a case report. Dent Update. 2017;44(5):444–6.CrossRef Shah K, Srinivasan B, Ethunandan M, Pratt C. Arteriovenous malformation of the jaws: a black hole for the GDP—a case report. Dent Update. 2017;44(5):444–6.CrossRef
2.
go back to reference Cenzato M, Dones F, Marcati E, Debernardi A, Scerrati A, Piparo M. Use of laser in arteriovenous malformation surgery. World Neurosurg. 2017;106:746–9.CrossRef Cenzato M, Dones F, Marcati E, Debernardi A, Scerrati A, Piparo M. Use of laser in arteriovenous malformation surgery. World Neurosurg. 2017;106:746–9.CrossRef
3.
go back to reference Al-Smadi A, Shokuhfar T, Johnston A, Alden TD, Bowman R, Shaibani A. The rare case of a large complex intraosseous cranial arteriovenous malformation with successful multidisciplinary management. J Neurosurg Pediatr. 2017;20(6):591–7.CrossRef Al-Smadi A, Shokuhfar T, Johnston A, Alden TD, Bowman R, Shaibani A. The rare case of a large complex intraosseous cranial arteriovenous malformation with successful multidisciplinary management. J Neurosurg Pediatr. 2017;20(6):591–7.CrossRef
4.
go back to reference Osada Y, Endo H, Sato K, Matsumoto Y, Matsumoto Y, Endo T, Fujimura M, et al. Successful presurgical endovascular management of venous sinus thrombosis associated with high-grade cerebral arteriovenous malformation: a case report. Interv Neuroradiol. 2017;23(6):656–60.CrossRef Osada Y, Endo H, Sato K, Matsumoto Y, Matsumoto Y, Endo T, Fujimura M, et al. Successful presurgical endovascular management of venous sinus thrombosis associated with high-grade cerebral arteriovenous malformation: a case report. Interv Neuroradiol. 2017;23(6):656–60.CrossRef
5.
go back to reference Park CK, Choi SK, Lee SH, Choi MK, Lim YJ. Clinical outcomes and radiosurgical considerations for pediatric arteriovenous malformation: influence of clinical features on obliteration rate. Childs Nerv Syst. 2017;33(12):2137–45.CrossRef Park CK, Choi SK, Lee SH, Choi MK, Lim YJ. Clinical outcomes and radiosurgical considerations for pediatric arteriovenous malformation: influence of clinical features on obliteration rate. Childs Nerv Syst. 2017;33(12):2137–45.CrossRef
6.
go back to reference Kumar A, Mittal M, Srivastava D, Jaetli V, Chaudhary S. Arteriovenous malformation of face. Contemp Clin Dent. 2017;8(3):482–4.CrossRef Kumar A, Mittal M, Srivastava D, Jaetli V, Chaudhary S. Arteriovenous malformation of face. Contemp Clin Dent. 2017;8(3):482–4.CrossRef
7.
go back to reference Neeta S, Rao R, Upadya M, Keerthi P. Arteriovenous malformation of face: a challenge to anesthesiologists. Anesth Essays Res. 2017;11(3):784–6.CrossRef Neeta S, Rao R, Upadya M, Keerthi P. Arteriovenous malformation of face: a challenge to anesthesiologists. Anesth Essays Res. 2017;11(3):784–6.CrossRef
8.
go back to reference Ramírez-Senent B, Abadal JM, Vázquez E, Lago I, Gálvez E, Araujo MA, et al. Endovascular management of a giant high-flow lower limb arteriovenous malformation. Vasc Endovasc Surg. 2017;51(8):572–6.CrossRef Ramírez-Senent B, Abadal JM, Vázquez E, Lago I, Gálvez E, Araujo MA, et al. Endovascular management of a giant high-flow lower limb arteriovenous malformation. Vasc Endovasc Surg. 2017;51(8):572–6.CrossRef
9.
go back to reference Diep J, Dandu K, Xiong M, Shulman SM, Gonzalez-Fiol AJ. Airway arteriovenous malformation in pregnancy. Can J Anaesth. 2017;64(10):1071–2.CrossRef Diep J, Dandu K, Xiong M, Shulman SM, Gonzalez-Fiol AJ. Airway arteriovenous malformation in pregnancy. Can J Anaesth. 2017;64(10):1071–2.CrossRef
10.
go back to reference Li J, Liu H, Ye L. Coil embolization for a vast and complex arteriovenous malformation in the posterior mediastinum. Int J Clin Exp Med. 2015;8(9):16838–41.PubMedPubMedCentral Li J, Liu H, Ye L. Coil embolization for a vast and complex arteriovenous malformation in the posterior mediastinum. Int J Clin Exp Med. 2015;8(9):16838–41.PubMedPubMedCentral
11.
go back to reference Liu AS, Mulliken JB, Zurakowski D, Fishman SJ, Greene AK. Extracranial arteriovenous malformations: natural progression and recurrence after treatment. Plast Reconstr Surg. 2010;125(4):1185–94.CrossRef Liu AS, Mulliken JB, Zurakowski D, Fishman SJ, Greene AK. Extracranial arteriovenous malformations: natural progression and recurrence after treatment. Plast Reconstr Surg. 2010;125(4):1185–94.CrossRef
12.
go back to reference Couto JA, Huang AY, Konczyk DJ, Goss JA, Fishman SJ, Mulliken JB, et al. Somatic MAP2K1 mutations are associated with extracranial arteriovenous malformation. Am J Hum Genet. 2017;100(3):546–54.CrossRef Couto JA, Huang AY, Konczyk DJ, Goss JA, Fishman SJ, Mulliken JB, et al. Somatic MAP2K1 mutations are associated with extracranial arteriovenous malformation. Am J Hum Genet. 2017;100(3):546–54.CrossRef
13.
go back to reference Idiz UO, Aysan E, Elmas L, Yildiz S, Akbulut H. The place of elastography in evaluating the efficacy of radiofrequency ablation of thyroid nodules. Am Surg. 2017;83(11):1228–34.CrossRef Idiz UO, Aysan E, Elmas L, Yildiz S, Akbulut H. The place of elastography in evaluating the efficacy of radiofrequency ablation of thyroid nodules. Am Surg. 2017;83(11):1228–34.CrossRef
14.
go back to reference Adam LC, Murali N, Chapiro J, Geschwind JF. Science to practice: molecular-targeted drug delivery in combination with radiofrequency ablation of liver cancer: a magic bullet? Radiology. 2017;285(2):333–5.CrossRef Adam LC, Murali N, Chapiro J, Geschwind JF. Science to practice: molecular-targeted drug delivery in combination with radiofrequency ablation of liver cancer: a magic bullet? Radiology. 2017;285(2):333–5.CrossRef
15.
go back to reference Carqueja IM, Sousa J, Mansilha A. Vascular malformations: classification, diagnosis and treatment. Int Angiol. 2018;37(2):127–42.CrossRef Carqueja IM, Sousa J, Mansilha A. Vascular malformations: classification, diagnosis and treatment. Int Angiol. 2018;37(2):127–42.CrossRef
16.
go back to reference Bastide G, Lefebvre D, Jaeger JF. The organogenesis and anatomy of vascular malformation. Int Angiol. 1990;9(3):137–40.PubMed Bastide G, Lefebvre D, Jaeger JF. The organogenesis and anatomy of vascular malformation. Int Angiol. 1990;9(3):137–40.PubMed
17.
go back to reference Achauer BM, Chang CJ, Vander Kam VM. Management of hemangioma of infancy: review of 245 patients. Plast Reconstr Surg. 1997;99(5):1301–8.CrossRef Achauer BM, Chang CJ, Vander Kam VM. Management of hemangioma of infancy: review of 245 patients. Plast Reconstr Surg. 1997;99(5):1301–8.CrossRef
18.
go back to reference Kohout MP, Hansen M, Pribaz JJ, Mulliken JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg. 1998;102(3):643–54.CrossRef Kohout MP, Hansen M, Pribaz JJ, Mulliken JB. Arteriovenous malformations of the head and neck: natural history and management. Plast Reconstr Surg. 1998;102(3):643–54.CrossRef
19.
go back to reference Hasnaoui N, Gérard E, Simon E, Guillet J. Massive bleeding after a tooth extraction: diagnosis of unknown arteriovenous malformation of the mandible, a case report. Int J Surg Case Rep. 2017;38:128–30.CrossRef Hasnaoui N, Gérard E, Simon E, Guillet J. Massive bleeding after a tooth extraction: diagnosis of unknown arteriovenous malformation of the mandible, a case report. Int J Surg Case Rep. 2017;38:128–30.CrossRef
20.
go back to reference Masiello R, Iadevaia C, Grella E, Tranfa C, Cerqua F, Rossi G, et al. A case of multiple unilateral pulmonary arteriovenous malformation relapse: efficacy of embolization treatment. Open Med (Wars). 2015;10(1):513–8. Masiello R, Iadevaia C, Grella E, Tranfa C, Cerqua F, Rossi G, et al. A case of multiple unilateral pulmonary arteriovenous malformation relapse: efficacy of embolization treatment. Open Med (Wars). 2015;10(1):513–8.
21.
go back to reference Funaki B, Funaki C. Embolization of high-flow arteriovenous malformation. Semin Interv Radiol. 2016;33(2):157–60.CrossRef Funaki B, Funaki C. Embolization of high-flow arteriovenous malformation. Semin Interv Radiol. 2016;33(2):157–60.CrossRef
22.
go back to reference Nassiri N, Crystal DT, Hoyt C, Shafritz R. Chronic refractory venous ulcer exacerbated by a congenital pelvic arteriovenous malformation successfully treated by transarterial Onyx embolization. J Vasc Surg Venous Lymphat Disord. 2017;5(3):417–20.CrossRef Nassiri N, Crystal DT, Hoyt C, Shafritz R. Chronic refractory venous ulcer exacerbated by a congenital pelvic arteriovenous malformation successfully treated by transarterial Onyx embolization. J Vasc Surg Venous Lymphat Disord. 2017;5(3):417–20.CrossRef
23.
go back to reference Andresen NS, Buatti JM, Tewfik HH, Pagedar NA, Anderson CM, Watkins JM. Radioiodine ablation following thyroidectomy for differentiated thyroid cancer: literature review of utility, dose, and toxicity. Eur Thyroid J. 2017;6(4):187–96.CrossRef Andresen NS, Buatti JM, Tewfik HH, Pagedar NA, Anderson CM, Watkins JM. Radioiodine ablation following thyroidectomy for differentiated thyroid cancer: literature review of utility, dose, and toxicity. Eur Thyroid J. 2017;6(4):187–96.CrossRef
24.
go back to reference Childs DD, Emory CL. Successful treatment of intramuscular venous malformation with image-guided radiofrequency ablation. J Vasc Interv Radiol. 2012;23(10):1391–3.CrossRef Childs DD, Emory CL. Successful treatment of intramuscular venous malformation with image-guided radiofrequency ablation. J Vasc Interv Radiol. 2012;23(10):1391–3.CrossRef
25.
go back to reference Cirimbei C, Rotaru V, Chitoran E, Pavaleanu O, Cirimbei SE. Immediate and long-term results of radiofrequency ablation for colorectal liver metastases. Anticancer Res. 2017;37(11):6489–94.PubMed Cirimbei C, Rotaru V, Chitoran E, Pavaleanu O, Cirimbei SE. Immediate and long-term results of radiofrequency ablation for colorectal liver metastases. Anticancer Res. 2017;37(11):6489–94.PubMed
26.
go back to reference Brown DB, Brandes SB. Radiofrequency ablation of a recanalized renal arteriovenous malformation. J Vasc Interv Radiol. 2005;16(3):403–6.CrossRef Brown DB, Brandes SB. Radiofrequency ablation of a recanalized renal arteriovenous malformation. J Vasc Interv Radiol. 2005;16(3):403–6.CrossRef
27.
go back to reference Chen AL. The relationship between ablation time, power and ablation range. Contemp Med. 2019;25(19):35–7.CrossRef Chen AL. The relationship between ablation time, power and ablation range. Contemp Med. 2019;25(19):35–7.CrossRef
Metadata
Title
Analysis of 18 complex diffuse arteriovenous malformation cases treated with percutaneous radiofrequency ablation
Authors
Chun-Xiao Ge
Mao-Zhong Tai
Tao Chen
Ke-Lei Li
Zhen-Guo Xu
Zhong-Ping Qin
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2021
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-021-02169-1

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