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Polidocanol Sclerotherapy Combined with Transarterial Embolization Using n-Butyl Cyanoacrylate for Extracranial Arteriovenous Malformations.
Cardiovasc Intervent Radiol. 2018 Jun; 41(6):856-866.CI

Abstract

PURPOSE

To assess the safety and effectiveness of polidocanol sclerotherapy combined with transarterial embolization using a liquid adhesive agent (n-butyl cyanoacrylate, NBCA) for treatment of extracranial arteriovenous malformations (AVMs).

MATERIALS AND METHODS

Twenty-three patients with symptomatic AVMs in the head and neck (6), upper (7) and lower extremity (10) with a mean age of 42 years (range 4-74) treated with polidocanol sclerotherapy were retrospectively assessed. AVMs were classified according to the angiographic morphology of the nidus. There were 2 type I, 6 type II, 6 type IIIa and 9 type IIIb. Arterial embolization using NBCA was performed to reduce arterial flow before sclerotherapy. Polidocanol mixed with contrast material or carbon dioxide was delivered by percutaneous direct puncture.

RESULTS

Treatment was successfully performed in all patients. In the mean follow-up period of 38 months, symptoms resolved or improved in 20/23 patients (87.0%). AVMs were devascularized 100% in 2 patients, 76-99% in 13, 50-75% in 7 and < 50% in 1. More than 50% devascularization was seen in 22 patients (95.6%). Two (8%) patients had complete remission, 17 (74%) had partial remission and 3 (13%) had no remission. There was no aggravation. Treatment was considered effective (complete and partial remission) in 20 patients (87.0%). Minor complications including localized arterial thrombosis (2) and spontaneously healing skin ulcer (1) were seen in 2 patients (8.7%). There were no major procedure-related complications.

CONCLUSION

Polidocanol sclerotherapy combined with transarterial embolization using NBCA is safe and effective for treating extracranial AVMs with an acceptable risk of minor complications.

Authors+Show Affiliations

Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan. akira@aichi-med-u.ac.jp.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.Department of Radiology, Aichi Medical University, 1-1 YazakoKarimata, Nagakute City, Aichi, 480-1195, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29417264

Citation

Kitagawa, Akira, et al. "Polidocanol Sclerotherapy Combined With Transarterial Embolization Using n-Butyl Cyanoacrylate for Extracranial Arteriovenous Malformations." Cardiovascular and Interventional Radiology, vol. 41, no. 6, 2018, pp. 856-866.
Kitagawa A, Yamamoto T, Matsunaga N, et al. Polidocanol Sclerotherapy Combined with Transarterial Embolization Using n-Butyl Cyanoacrylate for Extracranial Arteriovenous Malformations. Cardiovasc Intervent Radiol. 2018;41(6):856-866.
Kitagawa, A., Yamamoto, T., Matsunaga, N., Yamaji, M., Ikeda, S., Izumi, Y., Hagihara, M., Ota, T., & Ishiguchi, T. (2018). Polidocanol Sclerotherapy Combined with Transarterial Embolization Using n-Butyl Cyanoacrylate for Extracranial Arteriovenous Malformations. Cardiovascular and Interventional Radiology, 41(6), 856-866. https://doi.org/10.1007/s00270-017-1855-2
Kitagawa A, et al. Polidocanol Sclerotherapy Combined With Transarterial Embolization Using n-Butyl Cyanoacrylate for Extracranial Arteriovenous Malformations. Cardiovasc Intervent Radiol. 2018;41(6):856-866. PubMed PMID: 29417264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polidocanol Sclerotherapy Combined with Transarterial Embolization Using n-Butyl Cyanoacrylate for Extracranial Arteriovenous Malformations. AU - Kitagawa,Akira, AU - Yamamoto,Takahiro, AU - Matsunaga,Nozomu, AU - Yamaji,Mayako, AU - Ikeda,Shuji, AU - Izumi,Yuichiro, AU - Hagihara,Makiyo, AU - Ota,Toyohiro, AU - Ishiguchi,Tsuneo, Y1 - 2018/02/07/ PY - 2017/08/07/received PY - 2017/12/05/accepted PY - 2018/2/9/pubmed PY - 2018/10/3/medline PY - 2018/2/9/entrez KW - Arteriovenous malformations KW - Embolization KW - NBCA KW - Polidocanol KW - Sclerotherapy SP - 856 EP - 866 JF - Cardiovascular and interventional radiology JO - Cardiovasc Intervent Radiol VL - 41 IS - 6 N2 - PURPOSE: To assess the safety and effectiveness of polidocanol sclerotherapy combined with transarterial embolization using a liquid adhesive agent (n-butyl cyanoacrylate, NBCA) for treatment of extracranial arteriovenous malformations (AVMs). MATERIALS AND METHODS: Twenty-three patients with symptomatic AVMs in the head and neck (6), upper (7) and lower extremity (10) with a mean age of 42 years (range 4-74) treated with polidocanol sclerotherapy were retrospectively assessed. AVMs were classified according to the angiographic morphology of the nidus. There were 2 type I, 6 type II, 6 type IIIa and 9 type IIIb. Arterial embolization using NBCA was performed to reduce arterial flow before sclerotherapy. Polidocanol mixed with contrast material or carbon dioxide was delivered by percutaneous direct puncture. RESULTS: Treatment was successfully performed in all patients. In the mean follow-up period of 38 months, symptoms resolved or improved in 20/23 patients (87.0%). AVMs were devascularized 100% in 2 patients, 76-99% in 13, 50-75% in 7 and < 50% in 1. More than 50% devascularization was seen in 22 patients (95.6%). Two (8%) patients had complete remission, 17 (74%) had partial remission and 3 (13%) had no remission. There was no aggravation. Treatment was considered effective (complete and partial remission) in 20 patients (87.0%). Minor complications including localized arterial thrombosis (2) and spontaneously healing skin ulcer (1) were seen in 2 patients (8.7%). There were no major procedure-related complications. CONCLUSION: Polidocanol sclerotherapy combined with transarterial embolization using NBCA is safe and effective for treating extracranial AVMs with an acceptable risk of minor complications. SN - 1432-086X UR - https://www.unboundmedicine.com/medline/citation/29417264/Polidocanol_Sclerotherapy_Combined_with_Transarterial_Embolization_Using_n_Butyl_Cyanoacrylate_for_Extracranial_Arteriovenous_Malformations_ L2 - https://dx.doi.org/10.1007/s00270-017-1855-2 DB - PRIME DP - Unbound Medicine ER -