Long-term results of ethanol sclerotherapy with or without adjunctive surgery for head and neck arteriovenous malformations

Abstract

Introduction: Ethanol sclerotherapy has shown favorable short-term efficacy in managing head and neck arteriovenous malformation (AVM) which is well known for high recurrence rate after treatment. The purpose of this study was to report immediate treatment results and long-term follow-up results of ethanol sclerotherapy in patients with head and neck AVMs.Methods: We performed a retrospective review of 45 patients with head and neck AVMs treated between April 1997 and December 2013 by using ethanol sclerotherapy with or without adjunctive surgery. The degree of AVM eradication was analyzed, and complications per treatment session were recorded. Long-term treatment effectiveness was assessed with clinical and imaging follow-up.Conclusions: Ethanol sclerotherapy is effective for achieving long-term durable cure of head and neck AVMs. In patients with non-curable disease, it is also effective for symptom palliation and long-term disease control. However, given recurrence after interval disease-controlled period, long-term follow-up should be required to detect recurrence in patients with any residual lesion after treatment.Results: In total, 132 sclerotherapies were performed in the 45 patients, with a total angiographic eradication rate of 17.8 % (n = 8). Partial resolution was achieved in 34 patients, and three patients showed no response. Mean follow-up period was 56.6 months (range, 13–144 months). The long-term recurrence rate was 11.1 % (5/45), and all recurrences occurred more than 3 years after the treatment with interval disease-controlled period. The major complication rate was 3.8 % (5/132), and 34 minor complications (25.8 %) occurred. © 2015, Springer-Verlag Berlin Heidelberg.