Aurégan Jean-Charles, Lambot Karen, Dana Caroline, Brunelle Francis, Glorion Christophe, Pannier Stéphanie
Department of Pediatric Orthopedics, Necker-Enfants Malades Hospital, University Paris Descartes, Sorbonne Paris Cité, Paris, France.
J Hand Surg Am. 2013 Sep;38(9):1779-83. doi: 10.1016/j.jhsa.2013.06.015. Epub 2013 Aug 6.
An arteriovenous malformation (AVM) is a congenital lesion with high vascular flow resulting from direct connections between arteries and veins. Its treatment is often complex, and most authors recommend a multidisciplinary approach combining surgical and endovascular treatments. We report the case of a 6-month-old boy with a voluminous AVM of the left forearm inducing osteolysis of the radius, with bowing of its diaphysis and subsequent radial head dislocation. Surgical excision of the AVM was not possible, but 2 sequential coil embolizations achieved control of the lesion. After 3.5 years, the AVM was undetectable, and notable improvement was noted both in symptoms and radiographic findings. This case underlines how an AVM can have noteworthy influence on surrounding tissues and shows that embolization alone can achieve a satisfying midterm outcome even when surgery is not possible.
动静脉畸形(AVM)是一种先天性病变,由于动脉和静脉之间的直接连接导致血管血流高。其治疗通常很复杂,大多数作者建议采用手术和血管内治疗相结合的多学科方法。我们报告了一例6个月大男孩的病例,其左前臂有一个巨大的AVM,导致桡骨骨质溶解,骨干弯曲并随后出现桡骨头脱位。无法进行AVM的手术切除,但连续两次进行线圈栓塞实现了对病变的控制。3.5年后,AVM无法检测到,症状和影像学表现均有显著改善。该病例强调了AVM如何对周围组织产生显著影响,并表明即使无法进行手术,单独栓塞也能取得令人满意的中期结果。