Abstract
BackgroundThe 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.MethodsThe 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.ResultsOf 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.ConclusionThe “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.
Highlights
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
A total of 15 cases were examined via feeding artery arteriography through femoral artery intubation under digital subtraction angiography (DSA)
The lesions continued to develop and were not controlled, especially those in the tongue and the floor of the Discussion AV malformation is a vascular disease with a high flow velocity, which has the greatest influence on patient tissue structure and function [18]
Summary
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. Intracranial AV malformations are reported frequently [2,3,4,5], but extracranial AV malformations are relatively rare [6]. They often occur in the maxillofacial neck [7], torso, and extremities [8, 9]. Some patients who have undergone inappropriate treatment (including unilateral blood supply artery ligation, blood supply artery embolization, and partial lesion resection) are more likely to experience disease progression [12] and complex AV malformations, making the treatment more difficult
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