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The Efficiency and Safety of Ethanol Sclerotherapy for Labial Arteriovenous Malformations. J Vasc Surg Venous Lymphat Disord 2021; 10:713-720.e1. [PMID: 34774812 DOI: 10.1016/j.jvsv.2021.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 10/03/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE: Labial arteriovenous malformations, usually with accompanying cosmetic defects, pain, and bleeding, are aggressive with characteristics of high risk of recurrence and absence of effective treatment. This study presents a technique of sclerotherapy for labial arteriovenous malformations. METHODS Patients with labial arteriovenous malformations were treated with percutaneous ethanol sclerotherapy with or without polyvinyl alcohol particle embolization. The efficiency, complications, and recurrence rate were analyzed with imaging and clinical follow-up data. RESULTS Of the 15 patients, all patients received one or more treatment sessions, from which eight realized a cure (53.3%) and five had remission (33.3%). Two patients who did not achieve an effective result await further treatment. Four (26.7%) patients treated with ethanol sclerotherapy combined with polyvinyl alcohol particle embolization developed recurrence. No recurrence occurred in patients treated with only sclerotherapy (mean ± SD follow-up 17.2 ± 8.1 months). Thirteen patients developed transient complications: swelling, mild bleeding, and blistering. One patient had a postoperative scar of about 0.5 cm. CONCLUSIONS Ethanol sclerotherapy appears effective as a treatment for labial arteriovenous malformations. Careful application of the treatment can reduce the occurrence of complications.
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Liu X, Chen W, Shao B, Zhang X, Wang Y, Zhang S, Wu W. Mussel patterned with 4D biodegrading elastomer durably recruits regenerative macrophages to promote regeneration of craniofacial bone. Biomaterials 2021; 276:120998. [PMID: 34237507 DOI: 10.1016/j.biomaterials.2021.120998] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 06/19/2021] [Accepted: 06/25/2021] [Indexed: 12/11/2022]
Abstract
Crosstalk between bone marrow mesenchymal stem cells (BMSCs) and macrophages plays vital role in bone healing. By investigating the mechanism of collagen membrane-guided bone regeneration, we found compact structure and rapid membrane degradation compromised the duration of M2 macrophages influx, which restricts the recruitment of BMSCs that is essential for bone healing. To tackle this issue, a biodegrading elastomeric compound consisting of poly(glycerol sebacate) (PGS) and polycaprolactone (PCL) was fabricated into hierarchically porous membrane. The rational design of 3D microstructure enabled sufficient polydopamine (PDA) coating. Without any addition of growth factors, the 3D-patterned PDA membrane enables early and durable influx of M2 macrophages, which in turn promotes BMSCs recruitment and osteogenic differentiation. Furthermore, 4D-morphing of the membrane fully regenerates the dome shaped calvarial bone as well as arc-shape bone in peri-implant alveolar defect without filling xenogenous substitute. This study revealed the superiority of 3D printed microstructures in immunomodulatory materials. The availability of 4D-morphing for PGS/PCL construct expanded their advantages in reconstructing craniofacial bone.
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Affiliation(s)
- Xuzheng Liu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology Department of Oral & Maxillofacial Surgery School of Stomatology the Fourth Military Medical University, Xi'an, Shaanxi, PR China; Department of Oral Implant Center, People's Hospital of Inner Mongolia Autonomous Region, Hohhot, 010110, PR China
| | - Wanli Chen
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology Department of Oral & Maxillofacial Surgery School of Stomatology the Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Bo Shao
- Department of Oral Implant Center, People's Hospital of Inner Mongolia Autonomous Region, Hohhot, 010110, PR China
| | - Xinchi Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology Department of Oral & Maxillofacial Surgery School of Stomatology the Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Yinggang Wang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology Department of Oral & Maxillofacial Surgery School of Stomatology the Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Siqian Zhang
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology Department of Oral & Maxillofacial Surgery School of Stomatology the Fourth Military Medical University, Xi'an, Shaanxi, PR China
| | - Wei Wu
- State Key Laboratory of Military Stomatology & National Clinical Research Center for Oral Diseases & Shaanxi Key Laboratory of Stomatology Department of Oral & Maxillofacial Surgery School of Stomatology the Fourth Military Medical University, Xi'an, Shaanxi, PR China.
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Interdisciplinary treatment algorithm for facial high-flow arteriovenous malformations, and review of the literature. J Craniomaxillofac Surg 2018; 46:765-772. [DOI: 10.1016/j.jcms.2018.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/13/2018] [Accepted: 03/02/2018] [Indexed: 01/22/2023] Open
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Monteiro JLGC, de Arruda JAA, Figueiredo Leal JL, Batista LL, Célia de Aguiar Soares Carneiro S, do Egito Vasconcelos BC. Embolization as the Primary Treatment for Mandibular Arteriovenous Malformations: An Analysis of 50 Literature Reports and of an Illustrative Case. J Oral Maxillofac Surg 2018; 76:1695-1707. [PMID: 29551518 DOI: 10.1016/j.joms.2018.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/14/2018] [Accepted: 02/14/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE The aim of the present report is to describe 50 cases in the literature of mandibular arteriovenous malformations (AVMs) in which embolization was the primary treatment and to discuss details such as age, gender, materials used, outcome of embolization, time of follow-up, and intra- or postprocedure complications. An illustrative case in which reossification was noticed after embolization also is presented. PATIENTS AND METHODS The study was carried out in 2 steps. In the first, an electronic search without time restriction for embolization as the primary treatment for mandibular AVMs was performed on Medline through PubMed. In the second, the case of a patient with mandibular AVM and massive oral bleeding episodes is described after a long-term follow-up. RESULTS Clinical stability with the cessation of oral bleeding episodes was detected in 25 cases and 2 cases were planned for another embolization session. Clinical stability and reossification were detected in 23 of the 50 cases included. Complications were reported in 50% of cases, but most were minor and transient. CONCLUSION Currently, owing to more sophisticated imaging techniques, the diagnosis of mandibular AVMs is quicker and new, less invasive techniques that avoid surgical resection have proved effective. It should be emphasized that these techniques are not without complications and that long-term monitoring is extremely important.
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Affiliation(s)
- João Luiz Gomes Carneiro Monteiro
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Camaragibe, PE, Brazil.
| | - José Alcides Almeida de Arruda
- Postgraduate Student, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Jefferson Luiz Figueiredo Leal
- Postgraduate Student, Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco, Camaragibe, PE, Brazil
| | - Laécio Leitão Batista
- Head of Interventional Radiology, Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, PE, Brazil
| | - Suzana Célia de Aguiar Soares Carneiro
- Adjunct Professor, School of Dentistry, Faculdade Integrada de Pernambuco and Service of Oral and Maxillofacial Surgery, Hospital da Restauração, Recife, PE, Brazil
| | - Belmiro Cavalcanti do Egito Vasconcelos
- Assistant Professor, Department of Oral and Maxillofacial Surgery, School of Dentistry, Universidade de Pernambuco and Service of Oral and Maxillofacial Surgery, Hospital da Restauração, Recife, PE, Brazil
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Wang D, Su L, Han Y, Wang Z, Zheng L, Fan X. Absolute Ethanol Embolisation of Mandibular Arteriovenous Malformations Following Direct Percutaneous Puncture and Release of Coils via a Microcatheter. Eur J Vasc Endovasc Surg 2017; 53:862-869. [DOI: 10.1016/j.ejvs.2017.01.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 01/03/2017] [Indexed: 10/20/2022]
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Jafarian M, Dehghani N, Shams S, Esmaeelinejad M, Aghdashi F. Comprehensive Treatment of Upper Lip Arteriovenous Malformation. J Maxillofac Oral Surg 2016; 15:394-399. [PMID: 27752213 DOI: 10.1007/s12663-015-0836-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022] Open
Abstract
Arteriovenous malformations are uncommon congenital disorders in vascular development. They frequently involve craniofacial structures and result in a morphogenic abnormality with ominous arteriovenous shunting. We present a huge AVM of the upper lip in an 18-year-old patient who was successfully treated by the combination method of presurgical endovascular embolization and complete resection of the lesion. Subsequent surgical defect in upper lip, which involved more than two-third of the lip length, was reconstructed via Webster's modification of cheek advancement flap.
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Affiliation(s)
- Mohammad Jafarian
- Department of Oral and Maxillofacial Surgery, Dentofacial Deformity Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Dehghani
- Department of Oral and Maxillofacial Surgery, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Shams
- Department of Oral and Maxillofacial Surgery, Qom University of Medical Sciences, Qom, Iran
| | - Mohammad Esmaeelinejad
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Aghdashi
- Department of Oral and Maxillofacial Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Bendok BR, El Tecle NE, El Ahmadieh TY, Koht A, Gallagher TA, Carroll TJ, Markl M, Sabbagha R, Sabbagha A, Cella D, Nowinski C, Dewald JPA, Meade TJ, Samson D, Batjer HH. Advances and innovations in brain arteriovenous malformation surgery. Neurosurgery 2014; 74 Suppl 1:S60-73. [PMID: 24402494 DOI: 10.1227/neu.0000000000000230] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Arteriovenous malformations (AVMs) of the brain are very complex and intriguing pathologies. Since their initial description by Luschka and Virchow in the middle of the 19th century, multiple advances and innovations have revolutionized their management and surgical treatment. Here, we review the historical landmarks in the surgical treatment of AVMs and then illustrate the most recent and futuristic technologies aiming to improve outcomes in AVM surgeries. In particular, we examine potential advances in patient selection, imaging, surgical technique, neuroanesthesia, and postoperative neuro-rehabilitation and quantitative assessments. Finally, we illustrate how concurrent advances in radiosurgery and endovascular techniques might present new opportunities to treat AVMs more safely from a surgical perspective.
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Affiliation(s)
- Bernard R Bendok
- Northwestern Memorial Hospital, Departments of *Neurological Surgery, ‡Radiology, §Otolaryngology, and ¶Anesthesiology, Chicago, Illinois; ‖Northwestern University, McCormick School of Engineering, Department of Biomedical Engineering, Evanston, Illinois; Northwestern University, #Neuropsychology Institute, **Department of Medical Social Sciences, ‡‡Department of Physical Therapy and Human Movement Sciences, and §§Department of Chemistry, Chicago, Illinois; ¶¶University of Texas Southwestern, Department of Neurological Surgery, Dallas, Texas
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Comprehensive treatment and rehabilitation of a patient with maxillary arteriovenous malformation. J Craniofac Surg 2014; 25:e463-7. [PMID: 25148624 DOI: 10.1097/scs.0000000000001054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Arteriovenous malformations (AVMs) of the maxilla are rare and potentially life-threatening conditions that can pose a therapeutic dilemma. We reported the first case of maxillary AVM in a 15-year-old girl who was treated by marginal hemimaxillectomy including overlying palatal mucosa and immediate replantation of the segment after removing the AVM tissues and teeth and covering by a full-thickness pedicled temporal muscle flap rotated into the mouth. Then, this preserved bone underwent distraction osteogenesis and dental implant rehabilitation successfully. This method was previously used for the definitive treatment of mandibular AVMs, and in this case, we applied this method for the first time in maxillary AVMs. In conclusion, this surgical method may be considered as a safe, convenient, and effective treatment and reconstructive modality for such vascular malformations in the maxilla and restores function and symmetry of the jaws while obviating the need for bone harvesting and future major reconstructive operations.
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