Preoperative embolization of high-flow peripheral AVMs using plug and push technique with low-density NBCA/Lipiodol

Anh Binh Ho; Ngoc Son Nguyen; Vu Huynh Le; Duc Dung Nguyen; Anh Khoa Phan; Thanh Xuan Nguyen; Nhu Hiep Pham

doi:10.1093/jscr/rjaa316

Preoperative embolization of high-flow peripheral AVMs using plug and push technique with low-density NBCA/Lipiodol

J Surg Case Rep. 2020 Sep 21;2020(9):rjaa316. doi: 10.1093/jscr/rjaa316. eCollection 2020 Sep.

Authors

Anh Binh Ho¹, Ngoc Son Nguyen¹, Vu Huynh Le², Duc Dung Nguyen³, Anh Khoa Phan¹, Thanh Xuan Nguyen⁴, Nhu Hiep Pham⁴

Affiliations

¹ Department of Emergency and Interventional Cardiology, Hue Central Hospital, Hue city, Vietnam.
² Department of Interventional Radioneurology, Hue Central Hospital, Hue city, Vietnam.
³ Department of Cardiovascular and Thoracic Surgery, Hue Central Hospital, Hue city, Vietnam.
⁴ Department of Abdominal Emergency and Pediatric Surgery, Hue Central Hospital, Hue city, Vietnam.

Abstract

Arteriovenous malformations (AVMs) embolization is considered as a promising option either its single treatment or in combination with surgery, and the use of low-density N-butyl cyanoacrylate (NBCA)/Lipiodol is acceptable mixture agents but its application should be performed by experienced endovascular teams. We describe a successful case preoperative embolization of high-flow AVMs with low-density NBCA/Lipiodol. A 26-year-old male patient was hospitalized with a big pulsatile mass at the right thigh. Doppler ultrasound showed a mass with high systolic, and diastolic velocities coming from the right superficial femoral artery. Angiogram showed a large and high-flow AVM type IV, according to Yakes classification. Low-density NBCA/Lipiodol 12.5% were performed to obstruct all the nidus and feeding arteries. Extirpation surgery was implemented 4 days after the complete embolization procedure.

Publication types

Case Reports