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Trans-ophthalmic arterial ethanol embolotherapy for arteriovenous malformations: a single-center experience

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Abstract

Arteriovenous malformation (AVM)-derived ophthalmic artery (OphA) branches are not common, and their management is very challenging. We evaluated the safety and efficacy of Trans OphA ethanol embolotherapy for these lesions. We retrospectively reviewed 26 patients with AVMs fed by OphA, who underwent transOphA embolization using ethanol from February, 2015 to December, 2019. Sixty-six transOphA embolotherapy procedures (range, 1–4 procedures; mean, 2.5 procedures) were performed. Devascularization degree, visual field, visual acuity, and quality-of-life outcomes were compared and analyzed at follow up (mean, 32.6 months; month range 10–60). Complications were recorded. Twenty-five of the 26 patients (96%) reported complete or > 90% AVM devascularization while one patient (4%) showed > 70% devascularization. Eleven patients (42%) presented with visual acuity impairments; among them, 6 had improvements while 4 were completely relieved. Eight patients (30.7%) presented visual field defects, 3 had improvements while 4 were completely relieved. Ten patients (38.4%) presented with diplopia and exophthalmos with 2 being completely relieved while 6 had major improvements. Bleeding was controlled in all cases (100%). All patients (100%) exhibited cosmetic deformities with 17 being completely relieved. Moreover, all patients (100%) exhibited impaired daily life, which was resolved in 21 patients with 5 patients reporting major improvements. After endovascular treatment, there was no vision loss, death, or permanent disability in any patient. TransOphA ethanol embolotherapy is efficacious and safe for symptomatic resolution or improvement of AVMs fed by OphA with acceptable complications without the risk of visual impairment.

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Additional data and materials are available from the corresponding author upon reasonable request.

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Funding

This study received the Fundamental research program funding of the Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine (No. JYZZ076), Clinical Research Program of Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (No. JYLJ201801, JYLJ201911), the China Postdoctoral Science Foundation (No. 2017M611585) and the National Natural Science Foundation of China (No. 81871458).

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Authors and Affiliations

  1. Department of Interventional Therapy, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China

    Li-xin Su, Xin-yu Li, Ming-zhe Wen, De-ming Wang, Xin-dong Fan & Xi-tao Yang

  2. Department of Neurosurgery, Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, No. 280 Mo-He Road, Shanghai, 201999, China

    Xin-yu Li

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  1. Li-xin Su
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Contributions

Xi-tao Yang, Xin-dong Fan, Li-xin Su designed the experiments; Xin-yu Li, Ming-zhe Wen, De-ming Wang performed the experiments and wrote the manuscript, Xi-tao Yang reviewed the manuscript.

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Correspondence to Xi-tao Yang.

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All procedures involving human participants were in accordance with: the Scientific Research Projects Approval Determination of Independent Ethics Committee of Shanghai Ninth People’s Hospital, Shanghai JiaoTong University School of Medicine, and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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All patients provided signed written informed consents to participate.

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Li-xin Su, Xin-yu Li, Ming-zhe Wen and De-ming Wang are co-first authors.

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Su, Lx., Li, Xy., Wen, Mz. et al. Trans-ophthalmic arterial ethanol embolotherapy for arteriovenous malformations: a single-center experience. Neurosurg Rev 45, 2933–2940 (2022). https://doi.org/10.1007/s10143-022-01813-4

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  • DOI: https://doi.org/10.1007/s10143-022-01813-4

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