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Long-term results of ethanol sclerotherapy with or without adjunctive surgery for head and neck arteriovenous malformations

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Ethanol sclerotherapy has shown favorable short-term efficacy in managing head and neck arteriovenous malformation (AVM) which is well known for high recurrence rate after treatment. The purpose of this study was to report immediate treatment results and long-term follow-up results of ethanol sclerotherapy in patients with head and neck AVMs.

Methods

We performed a retrospective review of 45 patients with head and neck AVMs treated between April 1997 and December 2013 by using ethanol sclerotherapy with or without adjunctive surgery. The degree of AVM eradication was analyzed, and complications per treatment session were recorded. Long-term treatment effectiveness was assessed with clinical and imaging follow-up.

Results

In total, 132 sclerotherapies were performed in the 45 patients, with a total angiographic eradication rate of 17.8 % (n = 8). Partial resolution was achieved in 34 patients, and three patients showed no response. Mean follow-up period was 56.6 months (range, 13–144 months). The long-term recurrence rate was 11.1 % (5/45), and all recurrences occurred more than 3 years after the treatment with interval disease-controlled period. The major complication rate was 3.8 % (5/132), and 34 minor complications (25.8 %) occurred.

Conclusions

Ethanol sclerotherapy is effective for achieving long-term durable cure of head and neck AVMs. In patients with non-curable disease, it is also effective for symptom palliation and long-term disease control. However, given recurrence after interval disease-controlled period, long-term follow-up should be required to detect recurrence in patients with any residual lesion after treatment.

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea

    Byungjun Kim, Keonha Kim, Pyoung Jeon, Sungtae Kim, Hyungjin Kim & Hongsik Byun

  2. Department of Vascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Dongik Kim & Youngwook Kim

Authors
  1. Byungjun Kim
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  2. Keonha Kim
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  3. Pyoung Jeon
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  4. Sungtae Kim
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  7. Dongik Kim
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Correspondence to Keonha Kim.

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Kim, B., Kim, K., Jeon, P. et al. Long-term results of ethanol sclerotherapy with or without adjunctive surgery for head and neck arteriovenous malformations. Neuroradiology 57, 377–386 (2015). https://doi.org/10.1007/s00234-014-1483-3

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  • DOI: https://doi.org/10.1007/s00234-014-1483-3

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