Treatment of high-flow vascular malformations in the head and neck with arterial ligation followed by sclerotherapy
Journal
Annals of Plastic Surgery
Journal Volume
36
Journal Issue
2
Pages
147-153
Date Issued
1996
Author(s)
Abstract
The traditional treatment of high-flow vascular malformations consists of selective embolization, surgical removal, or a combination of both. Recurrence of the lesion and bleeding control are still the main problems, and the result of treatment is sometimes disappointing. We suggest treatment of these lesions with surgical ligation of the distal major feeding arteries followed by intravascular injection of a sclerosing agent (3% tetradecyl sulfate), and surgical excision and reconstruction when indicated. We have found this to be an effective treatment regimen. We present 14 cases of high- flow vascular malformations of the head and neck area treated with this approach, of which 4 cases developed skin necrosis. Three of these 4 cases of skin necrosis were later treated with skin grafting and, in 1 case, an upper arm skin tube flap was used for nasal tip reconstruction. Three cases underwent delayed reconstruction using tissue expanders. From a symptomatic and aesthetic point of view, preliminary satisfactory results were obtained. We feel that this approach is a good option for treating difficult, high- flow vascular malformations.
SDGs
Other Subjects
adolescent; adult; article; artificial embolism; bleeding; blood flow velocity; child; clinical article; congenital blood vessel malformation; female; head and neck disease; human; male; priority journal; sclerotherapy; surgical risk; surgical technique; Adolescent; Adult; Angiography; Arteries; Arteriovenous Malformations; Child; Child, Preschool; Combined Modality Therapy; Female; Head; Humans; Laser-Doppler Flowmetry; Ligation; Male; Neck; Necrosis; Postoperative Complications; Sclerotherapy; Skin; Skin Transplantation
Type
journal article