Percutaneous sclerotherapy of arteriovenous malformations of the maxillofacial soft tissues using fibrin glue combined with OK-432 and bleomycin following embolization in 13 consecutive patients

doi:10.19438/j.cjoms.2017.01.016

Abstract

Abstract: PURPOSE: To evaluate the clinical curative effect of percutaneous sclerotherapy of arteriovenous malformations (AVMs) of soft tissues of the maxillofacial region using fibrin glue combined with OK-432 and bleomycin. METHODS: Thirteen patients with AVMs of the maxillofacial region (8 males and 5 females; mean age: 28.2 years, range: 16-46 years) were treated with a percutaneous injection of fibrin glue combined with OK-432 and bleomycin for 3-5 times following super-selective intra-arterial embolization (SIAE). RESULTS: All patients had significant swelling postoperatively for up to 1 week without major complications. The follow-up period ranged from 14-58 months (mean: 27.4 months). Three lesions were completely involuted, eight lesions were mostly involuted, and other two lesions were partially involuted. None of the lesions showed minimal involution or non-involution. CONCLUSIONS: Percutaneous sclerotherapy using fibrin glue combined with OK-432 and bleomycin following SIAE provides a simple, safe, and reliable alternative treatment for AVMs of soft tissues of maxillofacial region.

Key words: Arteriovenous malformation, Fibrin glue, OK-432, Bleomycin, Embolization, Maxillofacial region

CLC Number:

R782.2

QIN Ze-man, HUANG Zhi-quan, CHEN Wei-liang, ZHAO Xiao-peng, CHEN Rui. Percutaneous sclerotherapy of arteriovenous malformations of the maxillofacial soft tissues using fibrin glue combined with OK-432 and bleomycin following embolization in 13 consecutive patients[J]. China Journal of Oral and Maxillofacial Surgery, 2017, 15(1): 73-76.

References

[1] Chen WL, Ye JT, Xu LF, et al. A multidisciplinary approach to treating maxillofacial arteriovenous malformations in children [J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 108(1): 41-47.
[2] Chen WL, Huang ZQ, Li JS, et al. Percutaneous sclerotherapy of juvenile nasopharyngeal angiofibroma using fibrin glue combined with OK-432 and bleomycin [J]. Int J Pediatr Otorhinolaryngol, 2010, 74(4): 422-425.
[3] Kohout MP, Hansen M, Pribaz JJ, et al. Arteriovenous malformations of the head and neck: natural history and management [J]. Plast Reconstr Surg, 1998, 102(3): 643-654.
[4] Rockman CB, Rosen RJ, Jacobowitz GR, et al. Transcatheter embolization of extremity vascular malformations: the long-term success of multiple interventions [J]. Ann Vasc Surg, 2003, 17(4): 417-423.
[5] Kohout MP, Hansen M, Pribaz JJ, et al. Arteriovenous malformations of the head and neck: natural history and management [J]. Plast Reconstr Surg, 1998, 102(3): 643-654.
[6] Chen W, Wang J, Li J, et al. Comprehensive treatment of arteriovenous malformations in the oral and maxillofacial region [J]. J Oral Maxillofac Surg, 2005, 63(10): 1484-1488.
[7] Lee BB, Bergan JJ. Advanced management of congenital vascular malformations: a multidisciplinary approach [J]. Cardiovasc Surg, 2002, 10(6): 523-533.
[8] Motamedi MH, Behnia H, Motamedi MR. Surgical technique for the treatment of high-flow arteriovenous malformations of the mandible [J]. J Craniomaxillofac Surg, 2000, 28(4): 238-242.
[9] Chen WL, Yang ZH, Bai ZB, et al. A pilot study on combination compartmentalization and sclerotherapy for the treatment of massive venous malformations of the face and neck [J]. J Plast Reconstr Aesthet Surg, 2008, 61(12): 1486-1492.
[10] 陈伟良, 汪延, 柴强, 等. 生物胶联合OK-432和平阳霉素治疗面颈部巨大静脉畸形 [J]. 中国口腔颌面外科杂志, 2010, 8(6): 555-557.
[11] Chen WL, Huang ZQ, Zhang DM, et al. Percutaneous sclerotherapy of massive venous malformations of the face and neck using fibrin glue combined with OK-432 and pingyangmycin [J]. Head Neck, 2010, 32(4): 467-472.
[12] Ogita S, Tsuto T, Tokiwa K, et al. Intracystic injection of OK-432: a new sclerosing therapy for cystic hygroma in children [J]. Br J Surg, 1987, 74(8): 690-691.
[13] Roggiani M, Stoehr JA, Leonard BA, et al. Analysis of toxicity of streptococcal pyrogenic exotoxin A mutants [J]. Infect Immun, 1997, 65(7): 2868-2875.
[14] Kullendorff CM. Efficacy of bleomycin treatment for symptomatic hemangiomas in children [J]. Pediatr Surg Int, 1997, 12(7): 526-528.

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