Ethanol Embolization of Arteriovenous Fistulas: A Primary Mode of Therapy

Wayne F. Yakes, James M. Luethke, Jean Jacques Merland, Kevin M. Rak, Dick D. Slater, Harris W. Hollis, Steve H. Parker, Alfredo Casasco, Armand Aymard, Jonathan Hodes, Kenneth D. Hopper, A. Thomas Stavros, Thomas E. Carter

Research output: Contribution to journalArticlepeer-review

69 Scopus citations

Abstract

Arteriovenous fistulas (AVFs) can be posttraumatic or congenital vascular malformations. In the initial arteriographic evaluation, chronic AVFs potentially can be confused with arteriovenous malformations (AVMs). The authors studied five patients with a single AVF and one patient with numerous AVFs. Three patients had undergone surgery for treatment of their AVFs, one patient had undergone isobutyl-2-cyanoacrylate (IBCA) embolization, and two patients had undergone no prior therapy. The AVFs recurred in the three patients who had undergone surgery and in the patient who had undergone IBCA embolization. All patients underwent ethanol embolization of their AVFs. Angiograms obtained immediately after embolization documented closure of all AVFs. At follow-up, none of the embolized lesions have recurred. The authors conclude that ethanol embolotherapy can cure these problematic lesions. Extreme caution, however, must be employed with the use of intravascular ethanol because nontarget embolization can potentially result in tissue devitalization. In this study, two patients developed a small focal area of skin necrosis that did not require skin grafting and healed with conservative management.

Original languageEnglish (US)
Pages (from-to)89-96
Number of pages8
JournalJournal of Vascular and Interventional Radiology
Volume1
Issue number1
DOIs
StatePublished - Jan 1 1990
Externally publishedYes

Keywords

  • AP
  • AV
  • AVF
  • AVM
  • Alcohol
  • Arteries, therapeutic blockade, 9*.1299
  • DSA
  • Fistula, arteriovenous, 9*.149, 9*.494
  • Fistula, therapeutic blockade, 9*.1299
  • IBCA
  • anteroposterior
  • arteriovenous
  • arteriovenous fistula
  • arteriovenous malformation
  • digital subtraction angiography
  • isobutyl-2-cyanoacrylate

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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