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Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy

PURPOSE: The aim of this study was to describe the treatment technique, outcomes, and complications of Schobinger stage IV head and neck arteriovenous malformations (HNAVMs) with associated high-output cardiac failure (HOCF) using ethanol and coils with the percutaneous suture technique. METHODS: Fr...

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Autores principales: Wen, Ming-zhe, Li, Xin-yu, Shen, Yu-chen, Wang, Zhen-feng, Zheng, Lian-zhou, Wang, De-ming, Fan, Xin-dong, Su, Li-xin, Yang, Xi-tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9662295/
https://www.ncbi.nlm.nih.gov/pubmed/36386341
http://dx.doi.org/10.3389/fcvm.2022.949558
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author Wen, Ming-zhe
Li, Xin-yu
Shen, Yu-chen
Wang, Zhen-feng
Zheng, Lian-zhou
Wang, De-ming
Fan, Xin-dong
Su, Li-xin
Yang, Xi-tao
author_facet Wen, Ming-zhe
Li, Xin-yu
Shen, Yu-chen
Wang, Zhen-feng
Zheng, Lian-zhou
Wang, De-ming
Fan, Xin-dong
Su, Li-xin
Yang, Xi-tao
author_sort Wen, Ming-zhe
collection PubMed
description PURPOSE: The aim of this study was to describe the treatment technique, outcomes, and complications of Schobinger stage IV head and neck arteriovenous malformations (HNAVMs) with associated high-output cardiac failure (HOCF) using ethanol and coils with the percutaneous suture technique. METHODS: From January 2015 to December 2019, 19 patients who had HNAVMs with associated HOCF were treated first with a percutaneous suture of the remarkably dilated dominant drainage vein (RDDOV) and subsequent embolization with coils and ethanol. The percutaneous suture of RDDOV was preferred to be performed, followed by the deployment of coils and the injection of absolute ethanol via transarterial approach, direct puncture approach, or both of them. Treatment outcomes and complication rates were evaluated at follow-up. RESULTS: A total of 19 patients who experienced HNAVMs with HOCF received 19 percutaneous suture procedures and 84 embolization procedures with ethanol and coils. Complete or >90% shunt reduction of the AVM was achieved in 16 patients. Notably, 19 patients with New York Heart Association (NYHA) stage II improved to stage I, and the symptom of dyspnea disappeared after embolization. The symptoms of five patients with bleeding disappeared. All patients presented with cosmetic concerns; Four were cured, and eight had a clearly recognizable improvement. Of note, 19 (100%) patients presented with impairment of daily life, which was resolved. The minor complications were encountered and recovered by the self. No major complications occurred. CONCLUSION: This study provides evidence that ethanol and coil embolotherapy is effective and safe in treating HOCF caused by HNAVMs with acceptable complications in these cases. The percutaneous suture technique for RDDOV management can act as an adjunct for embolotherapy.
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spelling pubmed-96622952022-11-15 Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy Wen, Ming-zhe Li, Xin-yu Shen, Yu-chen Wang, Zhen-feng Zheng, Lian-zhou Wang, De-ming Fan, Xin-dong Su, Li-xin Yang, Xi-tao Front Cardiovasc Med Cardiovascular Medicine PURPOSE: The aim of this study was to describe the treatment technique, outcomes, and complications of Schobinger stage IV head and neck arteriovenous malformations (HNAVMs) with associated high-output cardiac failure (HOCF) using ethanol and coils with the percutaneous suture technique. METHODS: From January 2015 to December 2019, 19 patients who had HNAVMs with associated HOCF were treated first with a percutaneous suture of the remarkably dilated dominant drainage vein (RDDOV) and subsequent embolization with coils and ethanol. The percutaneous suture of RDDOV was preferred to be performed, followed by the deployment of coils and the injection of absolute ethanol via transarterial approach, direct puncture approach, or both of them. Treatment outcomes and complication rates were evaluated at follow-up. RESULTS: A total of 19 patients who experienced HNAVMs with HOCF received 19 percutaneous suture procedures and 84 embolization procedures with ethanol and coils. Complete or >90% shunt reduction of the AVM was achieved in 16 patients. Notably, 19 patients with New York Heart Association (NYHA) stage II improved to stage I, and the symptom of dyspnea disappeared after embolization. The symptoms of five patients with bleeding disappeared. All patients presented with cosmetic concerns; Four were cured, and eight had a clearly recognizable improvement. Of note, 19 (100%) patients presented with impairment of daily life, which was resolved. The minor complications were encountered and recovered by the self. No major complications occurred. CONCLUSION: This study provides evidence that ethanol and coil embolotherapy is effective and safe in treating HOCF caused by HNAVMs with acceptable complications in these cases. The percutaneous suture technique for RDDOV management can act as an adjunct for embolotherapy. Frontiers Media S.A. 2022-10-26 /pmc/articles/PMC9662295/ /pubmed/36386341 http://dx.doi.org/10.3389/fcvm.2022.949558 Text en Copyright © 2022 Wen, Li, Shen, Wang, Zheng, Wang, Fan, Su and Yang. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Wen, Ming-zhe
Li, Xin-yu
Shen, Yu-chen
Wang, Zhen-feng
Zheng, Lian-zhou
Wang, De-ming
Fan, Xin-dong
Su, Li-xin
Yang, Xi-tao
Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy
title Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy
title_full Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy
title_fullStr Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy
title_full_unstemmed Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy
title_short Management of high-output cardiac failure caused by head and neck AVMs: Percutaneous suture-assisted ethanol and coil embolotherapy
title_sort management of high-output cardiac failure caused by head and neck avms: percutaneous suture-assisted ethanol and coil embolotherapy
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9662295/
https://www.ncbi.nlm.nih.gov/pubmed/36386341
http://dx.doi.org/10.3389/fcvm.2022.949558
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