Objective: To introduce superselective endovascular therapy under digital subtraction angiography for craniofacial arteriovenous malformations using absolute ethanol, and to assess the efficacy and complications of the method.
Methods: A retrospective review of patient medical and imaging records was performed. 8 patients (7 male, 1 female, 11-50 years) with craniofacial arteriovenous malformations underwent staged selective ethanol endovascular therapy (1-4 times, median 2 times). Clinical follow-up (8-24 months, mean 12.1 months) was performed in all patients, and results from imaging follow-up (2-6 months, mean 4.3 months) were available in 4 patients. Therapeutic outcomes were established by evaluating the clinical outcome of symptoms, as well as the degree of devascularization at follow-up angiography.
Results: 16 sessions of selective ethanol endovascular therapy were performed in 8 patients. 5 of 8 patients were cured, 2 had improvement, 1 had no change. Selective ethanol endovascular therapy was considered effective in 7 patients (87.5%). 4 patients will need further treatment sessions for residual arteriovenous malformations. Blistering, superficial skin necrosis and transient hemolysis occurred in 4 of 8 patients. All the complications were healed with observation. No major complications occurred.
Conclusion: Superselective ethanol endovascular therapy under digital subtraction angiography has the potential for cure of craniofacial arteriovenous malformations and is able to obtain excellent cosmetic results, and with acceptable risk of complications.