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Titolo:
Transcatheter embolization of complex pelvic vascular malformations: Results and long-term follow-up
Autore:
Jacobowitz, GR; Rosen, RJ; Rockman, CB; Nalbandian, M; Hofstee, DJ; Fioole, B; Adelman, MA; Lamparello, PJ; Gagne, P; Riles, TS;
Indirizzi:
NYU Med Ctr, Div Vasc Surg, New York, NY 10016 USA NYU Med Ctr New York NY USA 10016 , Div Vasc Surg, New York, NY 10016 USA NYU Med Ctr, Div Intervent Radiol, New York, NY 10016 USA NYU Med Ctr NewYork NY USA 10016 ntervent Radiol, New York, NY 10016 USA
Titolo Testata:
JOURNAL OF VASCULAR SURGERY
fascicolo: 1, volume: 33, anno: 2001,
pagine: 51 - 55
SICI:
0741-5214(200101)33:1<51:TEOCPV>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
CONGENITAL ARTERIOVENOUS-MALFORMATIONS; INTRA-ARTERIAL EMBOLIZATION; MANAGEMENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Jacobowitz, GR NYU Med Ctr, Div Vasc Surg, 530 1st Ave,Suite 6-F, New York, NY 10016 USA NYU Med Ctr 530 1st Ave,Suite 6-F New York NY USA 10016 USA
Citazione:
G.R. Jacobowitz et al., "Transcatheter embolization of complex pelvic vascular malformations: Results and long-term follow-up", J VASC SURG, 33(1), 2001, pp. 51-55

Abstract

Objectives: Vascular malformations of the pelvis are rare and present a difficult therapeutic challenge. Surgical treatment is notoriously difficult and carries a high likelihood of recurrence. Surgical proximal ligation of a feeding vessel may in fact be contraindicated, because it fan make subsequent transcatheter therapy impossible. The purpose of this study was to review our results with transcatheter embolization therapy in symptomatic complex pelvic vascular malformations in 35 patients. Methods: A retrospective review was conducted of a prospectively compiled database of all patients undergoing transcatheter therapy of a pelvic vascular malformation at our institution. Results: The mean age of the patients was 34 years (range, 16 months-66 years), and 51% were male. The most common presenting symptoms included pain (59%), a visible or palpable lesion (62%), associated palpable pulsation orthrill (44%), hemorrhage (27%), congestive heart failure (18%), and symptoms due to mass effect (35%), A significant number of patients had undergoneprevious, unsuccessful attempted surgical treatment of the lesion (32%). The most common type of lesion noted on arteriography was arteriovenous shunting (89%). Patients required a mean of 2.4 embolization procedures (range,1-11 procedures) over a mean period of 23.3 months (range, 1-144 months). The most common agents used were rapidly polymerizing acrylic adhesives. The most common vessels involved and treated were branches of the hypogastricartery (82%). More than one procedure were performed in 20 patients (53%). Seven were planned as staged embolizations, whereas 13 were due to residual or recurrent symptoms. Adjunctive surgical procedures were performed subsequent to embolization therapy in five patients (15%). Eighty-three percentof patients were asymptomatic or significantly improved at a mean follow-up of 84 months (range, 1-204 months). Conclusions: Pelvic vascular malformations are difficult to eradicate completely, and recurrences are common. Many patients require multiple therapeutic interventions. However, most of these difficult cases have good resultsin the long term. Transcatheter embolization plays a significant role in, and may be the treatment of choice for, symptomatic pelvic vascular malformations.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 11:24:31