Treatment of congenital arteriovenous malformation in children

Abstract

Objective To explore the clinical characteristics and therapeutic options for congenital arteriovenous malformation (AVM). Methods Retrospective analysis was performed for the clinical data of 8 hospitalized AVM children from January 2013 to August 2016. Treatments were reviewed and evaluated. There were 3 boys and 5 girls. As classified by site, the lesions were faciocervical (n=2), extremities (n=4) and trunk (n=2). Faciocervical lesion was treated with embolism and sclerotherapy. Surgery, embolism, sclerotherapy or combined therapy were applied for lesion on extremities and other lesions. Results All of them achieved excellent outcomes with a complete clinical recovery. After branch embolism, one case of left radial arterial AVM received secondary sclerotherapy. Pulsating mass disappeared and surface venous exposure persisted; two cases of auricular AVM improved obviously after embolism plus sclerotherapy; one case of right axillary AVM was free of any symptom after routine surgery. There was no recurrence during a 2-year follow-up period; one case of left infra-axillary AVM was symptom-free after simple embolism; two cases of Parkes-Weber syndrome were accompanied by thickening and swelling pain of extremities. There was a relief after embolism. Elevator shoes were provided; one case of left internal iliac artery AVM had a shrinking lesion after arterial embolism. There was a relief after two sessions of sclerotherapy. Follow-up was going on and later surgical resection planned. Conclusions Due to a complex pathogenesis, hemodynamic changes cause numerous pathophysiological conditions and therapeutic challenges. Treatment should be based on the location and classification of congenital AVM. Personalized treatment and inter-departmental cooperation may improve the efficiency of therapy. Key words: Arteriovenous malformation; Children; Therapy