TY - JOUR
T1 - Preoperative Epoxy Embolization Facilitates the Safe and Effective Resection of Venous Malformations in the Hand and Forearm
AU - Holly, Brian P.
AU - Patel, Yuval A.
AU - Park, James
AU - Fayad, Laura M.
AU - Deune, E. Gene
AU - Mitchell, Sally E.
AU - Weiss, Clifford R.
N1 - Publisher Copyright:
© 2016, © The Author(s) 2016.
PY - 2017/7/1
Y1 - 2017/7/1
N2 - Background: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization. Methods: We describe our initial experience with 11 patients who underwent surgical resection of VMs located in the hand and forearm after preembolization of 27 total sites using n-butyl-cyanoacrylate or ethylene vinyl alcohol copolymer. Results: Of the 11 patients treated, 5 had focal VMs, 3 had multifocal VMs, and 3 had diffuse VMs throughout the affected extremity. Four of the 5 patients with focal VMs were followed for at least 1 year, and no further treatment was required. All 3 of the patients with diffuse VMs have required ongoing treatment. No major functional impairments were reported, and there were no major procedure-related complications. Conclusions: Overall, embolization of the malformation before surgical resection facilitated localization, demarcation, and removal of the lesion.
AB - Background: The standard of care for treatment of low-flow venous malformations (VMs) is percutaneous sclerotherapy. These lesions are seldom surgically resected, especially if the malformation is in an anatomically difficult location. Percutaneous sclerotherapy is safe and effective. However, the drawbacks to sclerotherapy are the need for repeated treatments and risks of skin ulceration, deep venous thrombosis, scarring/contractures, and nerve damage. Surgical resection can be difficult because of intraoperative bleeding, intraoperative lesional decompression, and difficulty in localization. Methods: We describe our initial experience with 11 patients who underwent surgical resection of VMs located in the hand and forearm after preembolization of 27 total sites using n-butyl-cyanoacrylate or ethylene vinyl alcohol copolymer. Results: Of the 11 patients treated, 5 had focal VMs, 3 had multifocal VMs, and 3 had diffuse VMs throughout the affected extremity. Four of the 5 patients with focal VMs were followed for at least 1 year, and no further treatment was required. All 3 of the patients with diffuse VMs have required ongoing treatment. No major functional impairments were reported, and there were no major procedure-related complications. Conclusions: Overall, embolization of the malformation before surgical resection facilitated localization, demarcation, and removal of the lesion.
KW - embolization
KW - epoxy
KW - surgical resection
KW - vascular anomaly
KW - venous malformations
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U2 - 10.1177/1558944716669798
DO - 10.1177/1558944716669798
M3 - Article
C2 - 28644938
AN - SCOPUS:85021273213
VL - 12
SP - 335
EP - 341
JO - Hand
JF - Hand
SN - 1558-9447
IS - 4
ER -