Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand
Summary:. A significant proportion of high-flow arteriovenous malformations (AVMs) in the hand are complex to treat due to their multicentricity, size, and risk of jeopardizing distal circulation. Therefore, AVMs are frequently considered “inoperable.” We present the case of a multifocal recurrent A...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2023-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005159 |
| _version_ | 1797732725665300480 |
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| author | Rafael Reynoso, MD Alfonso Echeverría, MD Carlos Alberto Saldivar Rodea, MD |
| author_facet | Rafael Reynoso, MD Alfonso Echeverría, MD Carlos Alberto Saldivar Rodea, MD |
| author_sort | Rafael Reynoso, MD |
| collection | DOAJ |
| description | Summary:. A significant proportion of high-flow arteriovenous malformations (AVMs) in the hand are complex to treat due to their multicentricity, size, and risk of jeopardizing distal circulation. Therefore, AVMs are frequently considered “inoperable.” We present the case of a multifocal recurrent AVM treated in conjunction with the interventional radiology department, with intra-arterial embolization and excision followed by immediate distal revascularization to replace the resulting arterial deficit. This is a case of a 24-year-old woman with a high-flow multifocal AVM in her right hand, partially excised 2 years ago, showing a pulsatile mass in the palm and dorsum of the right hand, and a reporting pain of 8 of 10 on the visual analogue scale. The procedure was performed in our hybrid operating room. This procedure lasted 4 hours, with intraoperative bleeding of 75 mL. Three weeks after the procedure, patency and good circulation of the three revascularized fingers was demonstrated using arteriography and no evidence of vascular anomalies were found. No skin loss occurred, and no reintervention was required. For radical excision of this complex high-flow recurrent AVM, detailed intraoperative documentation of its afferent and immediate embolization with gelatin-based hemostatic agents allowed its obliteration with a low reactive material. We consider that this approach might be an option to treat AVMs that are currently considered inoperable. |
| first_indexed | 2024-03-12T12:18:43Z |
| format | Article |
| id | doaj.art-65d4d01190ea4dd1b6cb96c87029964e |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-03-12T12:18:43Z |
| publishDate | 2023-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-65d4d01190ea4dd1b6cb96c87029964e2023-08-30T06:13:49ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742023-08-01118e515910.1097/GOX.0000000000005159202308000-00008Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the HandRafael Reynoso, MD0Alfonso Echeverría, MD1Carlos Alberto Saldivar Rodea, MD2From the * Department of Plastic and Reconstructive Surgery, General Hospital of Mexico, Mexico City, MexicoFrom the * Department of Plastic and Reconstructive Surgery, General Hospital of Mexico, Mexico City, Mexico† Department of Interventional Radiology, General Hospital of Mexico, Mexico City, Mexico.Summary:. A significant proportion of high-flow arteriovenous malformations (AVMs) in the hand are complex to treat due to their multicentricity, size, and risk of jeopardizing distal circulation. Therefore, AVMs are frequently considered “inoperable.” We present the case of a multifocal recurrent AVM treated in conjunction with the interventional radiology department, with intra-arterial embolization and excision followed by immediate distal revascularization to replace the resulting arterial deficit. This is a case of a 24-year-old woman with a high-flow multifocal AVM in her right hand, partially excised 2 years ago, showing a pulsatile mass in the palm and dorsum of the right hand, and a reporting pain of 8 of 10 on the visual analogue scale. The procedure was performed in our hybrid operating room. This procedure lasted 4 hours, with intraoperative bleeding of 75 mL. Three weeks after the procedure, patency and good circulation of the three revascularized fingers was demonstrated using arteriography and no evidence of vascular anomalies were found. No skin loss occurred, and no reintervention was required. For radical excision of this complex high-flow recurrent AVM, detailed intraoperative documentation of its afferent and immediate embolization with gelatin-based hemostatic agents allowed its obliteration with a low reactive material. We consider that this approach might be an option to treat AVMs that are currently considered inoperable.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005159 |
| spellingShingle | Rafael Reynoso, MD Alfonso Echeverría, MD Carlos Alberto Saldivar Rodea, MD Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand Plastic and Reconstructive Surgery, Global Open |
| title | Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand |
| title_full | Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand |
| title_fullStr | Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand |
| title_full_unstemmed | Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand |
| title_short | Super Selective Embolization and Immediate Resection of a High-flow Arteriovenous Malformation in the Hand |
| title_sort | super selective embolization and immediate resection of a high flow arteriovenous malformation in the hand |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000005159 |
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