Sarti Giuseppe, Barbato Giovanni, Tiralongo Francesco, Santini Gianpaolo, Arienzo Francesco, Nilo Davide, Tortora Fabio, Reginelli Alfonso, Comune Rosita, Borrelli Maria, Tamburrini Stefania, Basile Antonio, Scaglione Mariano
Department of Advanced Biomedical Sciences, University "Federico II", Via Pansini, 5, 80131 Naples, Italy.
Department of Interventional Radiology, Ospedale del Mare ASL Napoli1 Centro, 80142 Naples, Italy.
Tomography. 2025 Jun 26;11(7):75. doi: 10.3390/tomography11070075.
Extracranial arteriovenous malformations (AVMs) are rare congenital vascular anomalies that often require endovascular treatment due to symptoms such as pain, bleeding, or functional impairment. Endovascular strategies include arterial, venous, or combined embolization approaches; however, recurrence remains a major challenge. We retrospectively evaluate the technical success, safety, and clinical outcomes of arterial-only versus combined arterial and venous embolization for the treatment of extracranial AVMs.
This single-center retrospective study included 14 patients (mean age 31.8 ± 21.7 years; 64% female) with symptomatic extracranial AVMs (Schobinger stage II) treated between 2017 and 2023. AVMs were classified angiographically (Yakes classification) and treated with embolization via arterial or combined access routes. The primary endpoint was technical success (defined as angiographic nidus occlusion), while secondary endpoints included clinical recurrence and procedure-related complications. Follow-up included clinical and Doppler ultrasound assessments.
Nine patients (64%) underwent arterial embolization alone; five (36%) received combined arterial and venous embolization, including Lauromacrogol injection via direct puncture. Technical success was achieved in all cases (100%). Clinical recurrence occurred in two patients (14%), both from the arterial-only group. One major complication (tongue ischemia) occurred in a single patient (7%). No complications or recurrences were observed in the combined treatment group. Statistical analysis showed no significant difference in recurrence or complication rates between groups.
颅外动静脉畸形（AVM）是罕见的先天性血管异常，由于疼痛、出血或功能障碍等症状，通常需要进行血管内治疗。血管内治疗策略包括动脉、静脉或联合栓塞方法；然而，复发仍然是一个主要挑战。我们回顾性评估单纯动脉栓塞与动脉和静脉联合栓塞治疗颅外AVM的技术成功率、安全性和临床结果。
这项单中心回顾性研究纳入了2017年至2023年间接受治疗的14例有症状的颅外AVM患者（Schobinger II期）（平均年龄31.8±21.7岁；64%为女性）。通过血管造影对AVM进行分类（Yakes分类），并通过动脉或联合入路进行栓塞治疗。主要终点是技术成功（定义为血管造影显示病灶闭塞），次要终点包括临床复发和与手术相关的并发症。随访包括临床和多普勒超声评估。
9例患者（64%）仅接受动脉栓塞；5例（36%）接受动脉和静脉联合栓塞，包括通过直接穿刺注射聚桂醇。所有病例均实现技术成功（100%）。2例患者（14%）出现临床复发，均来自单纯动脉栓塞组。1例患者（7%）发生1例严重并发症（舌缺血）。联合治疗组未观察到并发症或复发。统计分析显示两组之间的复发率或并发症发生率无显著差异。
