PURPOSE: To evaluate the efficacy and safety of a novel retrograde transvenous embolization technique of peripheral arteriovenous malformations (AVMs) using Onyx. MATERIALS AND METHODS: We conducted a retrospective analysis of all patients who underwent transvenous retrograde Onyx embolization of peripheral AVMs with dominant venous outflow over a 29-month period. The embolization is aimed at retrograde filling of the nidus after building a solid plug in the dominant venous outflow (push-through). Classification, clinical signs, technical aspects, clinical and technical success rates, and complications were recorded. Short-term outcome was assessed. RESULTS: 11 Symptomatic patients (8 female; mean age 31.4 years) were treated at our Vascular Anomalies Center with this method between January 2012 and May 2014. The AVMs were located on the upper extremity (n = 3), pelvis (n = 2), buttock (n = 2), and lower extremity (n = 4). Retrograde embolization was successfully carried out after preparatory transarterial-flow reduction in eight cases (73 %) and venous-flow reduction with Amplatzer Vascular Plugs in four cases (36 %). Complete devascularization (n = 10; 91 %) or 95 % devascularization (n = 1; 9 %) led to complete resolution (n = 8; 73 %) or improvement of clinical symptoms (n = 3; 27 %). One minor complication occurred (pain and swelling). During a mean follow-up time of 8 months, one clinically asymptomatic recurrence of AVM was detected. CONCLUSION: Initial results suggest that retrograde transvenous Onyx embolization of peripheral AVMs with dominant venous outflow is a safe and effective novel technique with a low complication rate.
PURPOSE: To evaluate the efficacy and safety of a novel retrograde transvenous embolization technique of peripheral arteriovenous malformations (AVMs) using Onyx. MATERIALS AND METHODS: We conducted a retrospective analysis of all patients who underwent transvenous retrograde Onyx embolization of peripheral AVMs with dominant venous outflow over a 29-month period. The embolization is aimed at retrograde filling of the nidus after building a solid plug in the dominant venous outflow (push-through). Classification, clinical signs, technical aspects, clinical and technical success rates, and complications were recorded. Short-term outcome was assessed. RESULTS: 11 Symptomatic patients (8 female; mean age 31.4 years) were treated at our Vascular Anomalies Center with this method between January 2012 and May 2014. The AVMs were located on the upper extremity (n = 3), pelvis (n = 2), buttock (n = 2), and lower extremity (n = 4). Retrograde embolization was successfully carried out after preparatory transarterial-flow reduction in eight cases (73 %) and venous-flow reduction with Amplatzer Vascular Plugs in four cases (36 %). Complete devascularization (n = 10; 91 %) or 95 % devascularization (n = 1; 9 %) led to complete resolution (n = 8; 73 %) or improvement of clinical symptoms (n = 3; 27 %). One minor complication occurred (pain and swelling). During a mean follow-up time of 8 months, one clinically asymptomatic recurrence of AVM was detected. CONCLUSION: Initial results suggest that retrograde transvenous Onyx embolization of peripheral AVMs with dominant venous outflow is a safe and effective novel technique with a low complication rate.
Authors: Vanessa F Schmidt; Max Masthoff; Richard Brill; Peter B Sporns; Michael Köhler; Victor Schulze-Zachau; Martin Takes; Denis Ehrl; Daniel Puhr-Westerheide; Wolfgang G Kunz; Mwivano Dunstan Shemwetta; Eric M Mbuguje; Azza A Naif; Abizer Sarkar; Jens Ricke; Max Seidensticker; Walter A Wohlgemuth; Moritz Wildgruber Journal: Cardiovasc Intervent Radiol Date: 2022-06-02 Impact factor: 2.797
Authors: Vanessa F Schmidt; Max Masthoff; Veronika Vielsmeier; Caroline T Seebauer; Özlem Cangir; Lutz Meyer; Antje Mükke; Werner Lang; Axel Schmid; Peter B Sporns; Richard Brill; Walter A Wohlgemuth; Natascha Platz Batista da Silva; Max Seidensticker; Regina Schinner; Julia Küppers; Beate Häberle; Frank Haubner; Jens Ricke; Martin Zenker; Melanie A Kimm; Moritz Wildgruber Journal: Cardiovasc Intervent Radiol Date: 2022-10-19 Impact factor: 2.797
Authors: Maliha Sadick; Walter A Wohlgemuth; Roland Huelse; Bettina Lange; Thomas Henzler; Stefan O Schoenberg; Haneen Sadick Journal: Eur J Radiol Open Date: 2017-05-14