International Journal of Cardiovascular and Thoracic Surgery
Volume 4, Issue 3, May 2018, Pages: 20-25
Received: May 12, 2018;
Accepted: Jun. 4, 2018;
Published: Jun. 28, 2018
Views 742 Downloads 58
Momar Sokhna Diop, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Papa Adama Dieng, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Magaye Gaye, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Ndeye Fatou Sow, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Amadou Gabriel Ciss, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Papa Salmane Ba, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Papa Amath Diagne, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Souleymane Diatta, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Assane N’diaye, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Mouhamadou N’diaye, Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal
Arteriovenous malformations (AVM) are vascular malformations, broadband, formed of arterial and venous dysmorphic vessels interconnected directly without transition in a capillary bed. Arteriovenous malformation surgery is particularly demanding owing to the need to control bleeding. This is probably one of the most critical moments of arteriovenous malformation surgery. The purpose of this study is to analyzed the clinical aspects and evaluate the results of surgery in the treatment of these AVMs. This is a retrospective and descriptive study that took place in Dakar over a period from January 2004 to December 2017 on patients operated for arteriovenous malformations. The total number of our series was 11 cases. These AVMs represented 32.35% of all tumors and vascular malformations operated during this period. The mean age at surgery was 25 years old [1 year-56 years old]. A male predominance was noted with 7 male to 4 female (sex ratio 1.75). The average time of consultation was 8.3 years [1 months-30 months]. The main reason for consultation was the appearance of a mass in 11 cas. We noted a notion of traumatism or recent surgery were done in 4/11 before the onset of symptoms. The location of the lesions was at the head or the face (5 cases), neck (1 case), the upper member (2 cases), the lower member (3 cases). No multiple location were noted. After physical examination, two patients were classified Schobinger stage 1, stage 2 in 7 cases, 2 cases in stage 3. No patient was classified stage 4. The vascular Doppler ultrasound was performed in 10 cases (91%) and allowed to confirm the diagnosis in 10 cases. The CT angiography was performed in 8 cases (73%). It elicited the feeding artery and draining veins, the number of nidus and topography. We found 6 truncal AVM and 5 extratruncal including 4 limited. A first embolization was performed in 2 cases (18.2%). A one-stage surgery was performed in 7 cases and two times in 4 cases. The average hospital stay was 15 days [3 days-60 days]. The average healing time was 18 days [15 days-30 days]. Operative mortality as early mortality was zero. Late mortality was zero. The average follow-up time was 50.3 months [2 months-96 months]. In recent years, the multidisciplinary approach of tumors and vascular malformations has made important advances in the delineation of nosological frameworks and in the understanding of the natural history and structure of these complex lesions. This is why the treatment of these AVMs requires a multidisciplinary consultation exchange between vascular surgeons, plastic surgeons, interventional radiologists and anesthetists.
Momar Sokhna Diop,
Papa Adama Dieng,
Ndeye Fatou Sow,
Amadou Gabriel Ciss,
Papa Salmane Ba,
Papa Amath Diagne,
Arteriovenous Malformations: Clinical Aspects and Surgical Results, International Journal of Cardiovascular and Thoracic Surgery.
Vol. 4, No. 3,
2018, pp. 20-25.
Garzon MC, Huang JT, Enjorlas O, Frieden IJ. Vascular malformations. Part I. J Am Acad Dermatol 2007; 56: 353-70.
Naouri M, Lorette G, Barbier C, Zakine G, Herbreteau D. Malformations artérioveineuses. Presse Med 2010; 39: 465-470.
Raghu M., De R., Higgins N., Axon P. Spontaneous arteriovenous malformation of the external auditory meatus. J Laryngol Otol. 2004; 118: 912-3.
De Miguel R, Lopez-Gutierrez JC, Boixeda P. Arteriovenous Malformations: A Diagnostic and therapeutic challenge. Actas Dermosifiliogr 2014; 105 (4): 347-358.
Kim JY, Kim DI, Do YS, Lee BB, Kim YW, Shin SW et al. Surgical treatment for congenital arteriovenous malformation: 10 years experience. Euro J. Vasc Endovasc. Surg 2006; 32: 101-106.
Lee BB, Do YS, Yakes W, Kim DI, Mattassi R, Hyon WS. Management of artriovenous malformations: A multidisciplinary approach. Journal of vascular surgery 2004; 39: 590-600.
Diarra O, Ba M, Ndiaye A, Ciss G, Dia A, Ndiaye M. Anomalies vasculaires congénitales en chirurgie vasculaire en milieu africain: à propos de 28 cas colligés au CHU de Dakar. Journal des maladies vasculaires 2003; 28 (1): 24-29.
Guero S. Tumeurs et malformations vasculaires des members. Chirurgie de la main 2007; 26: 278-287.
Saeed Kilani M., Lepennec V., Petit P., Magalon D., Casanova D., Bartoli J-M., Vidal V. Embolization of peripheral high-flow arteriovenous malformation with Onyx. Diagnostic and Interventional Imaging (2017) 98, 217-226.
Enjorlas O, Logeart I, Gelbert F, Lemarchand-Venencie F, Reizine D, Guichard JP et al. Malformations artérioveineuses: étude de 200 cas. Ann Dermatol Venereol 2000; 127 (1): 17-22.
Liu AS, Mulliken JB, Zurakowski D, Fishman SJ, Greene AK. Extracranial arteriovenous malformations: natural progression and recurrence after treatment. Plast Reconstr Surg 2010; 125: 1185-94.
Guillet A, Maruani A, Berton M, Herbreteau P, Perret C, Connault J et al. Signes cliniques précoces et pronostic à long terme des malformations artérioveineuses cutanées distales de membre: étude rétrospective multicentrique de 19 patients. Annales de dermatologie et vénéréologie 2014; 141 (12): 299-300.
Osuga K, Hori S, Kitayoshi H, Khankan AA, Okada A, Sugiura T et al. Embolization of high flow arteriovenous malformations: experience with use of superabsorbent polymer microspheres. Journal of vascular interventional radiology 2002; 13: 1125-1133.
Hyodoh H, Hori M, Akiba H, Tamakawa M, Hyodoh K, Hareyama M. Peripheral vascular malformations: imaging, treatment approaches and therapeutic issues. Radiographics 2005; 25: 159-171.
Johnson JB, Cogswell PM, Mcknsick MA, Binkovitz LA, Riederer SJ, Young PM. Pretreatment imaging of peripheral vascular malformations. Journal of vascular diagnostics 2014; 2: 121-126.
Laurian C, Fransceschi C, Herbreteau D, Enjorlas O. Traitement chirurgical des malformations vasculaires des membres. EMC Chirurgie. 2004; 1: 100-124.
Kansy K., Bodem J., Engel M., Freudlsperger C., Mohlenbruch M. A., Herweh C., Bendszus M., Hoffmann J., Kargus S. Interdisciplinary treatment algorithm for facial high-flow arteriovenous malformations, and review of the literature. Journal of Cranio-Maxillo-Facial Surgery 46 (2018) 765-772.
Fernandez AL. Surgical treatment of vascular malformations. An Sist Sanit Navar 2004; 27 (Suppl 1): 127-132.
Riles TS, Berenstein A, Fisher FS, Persky MS, Madrid M. Reconstruction of the ligated external carotid artery for embolisation of cervicofacial arteriovenous malformations. Journal of vascular surgery 1993; 17 (3): 491-498.
Chen W, Ye J, Xu L, Huang Z, Zhang D. A mutidisciplinary approach to treating maxillofacial arteriovenous malformation in children. Oral surg oral med oral pathol oral radiol endod 2009; 108: 41-47.
White RI, Pollak J, Persing J, Henderson KJ, Thomson JG, Burdge CM. Long term outcome of embolotherapy and surgery for high-flow extremity arteriovenous malformations. JVIR 2000; 11: 1285-1295.
Su L., Wang D., Han Y., Wang Z., Zheng L., Fan X. Absolute Ethanol Embolization of Infiltrating-diffuse Extracranial Arteriovenous Malformations in the Head and Neck. Eur J Vasc Endovasc Surg (2015) 50, 114-121.
Mulliken JB. Cutaneous vascular anomalies. Semin Vasc Surg 1993; 6: 204-18.
Lee BB, Do YS, Byun HS, Choo IW, Kim DI, Huk SH. Advanced management of venous malformation (VM) with ethanol sclerotherapy: mid-term results. J Vasc Surg 2003; 37: 533-8.
Juszkat R, Zabicki B, Checinski P, Gabriel M, Matar N. Endovascular treatment of arteriovenous malformation. Aesth Plast Surg 2009; 33: 639-642.
Kim S. H., Han S. H., Song Y., Park C. S., Song J. J. Arteriovenous malformation of the external ear: a clinical assessment with a scoping review of the literature. Braz J Otorhinolaryngol. 2017; 83 (6): 683-690.