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. 2022 Jul 18:2022:1022729.
doi: 10.1155/2022/1022729. eCollection 2022.

Liquid Embolization of Peripheral Arteriovenous Malformations with Ethylene-Vinyl Alcohol Copolymer in Neonates and Infants

Jochen Pfeifer  1 , Walter A Wohlgemuth  2 , Hashim Abdul-Khaliq  1
Affiliations

Liquid Embolization of Peripheral Arteriovenous Malformations with Ethylene-Vinyl Alcohol Copolymer in Neonates and Infants

Jochen Pfeifer et al. Cardiovasc Ther. .

Abstract

In the postnatal period, extensive peripheral arteriovenous malformations (AVM) are associated with high morbidity, especially when localized in the liver. Their urgent treatment is always a challenging problem in neonates and infants. We analyzed four consecutive children aged three days to three years who underwent eight liquid embolization procedures with ethylene-vinyl alcohol copolymer. The AVM were situated on the thoracic wall, in the liver, and on the lower leg. In three cases, the malformations showed total regression. The tibial AVM degenerated widely. If impaired beforehand, cardiac or hepatic function normalized after the interventions. There were no embolization-associated complications such as nontarget embolization or tissue ischemia. We conclude that application of ethylene-vinyl alcohol copolymer seems to be a safe therapeutic option and can be used in neonates and infants with peripheral AVM in consideration of the agent's characteristics. Nevertheless, there are still hardly any data concerning young children.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Imaging of the thoracic AVM in patient 2. (a) Angiographical imaging after injection of Solutrast 300® via a transarterial catheter (asterisk) into the feeding arteries deriving from the right subclavian artery. (b) Angiographical imaging after injection of radiopaque Onyx®. (c) Radiographic imaging (X-ray) of the thorax after the last embolization.
Figure 2
Figure 2
Imaging of the hepatic AVM in patient 4. (a) Angiographical imaging after injection of Solutrast 300® into the feeding arteries via transarterial catheter (asterisk). (b) Angiographical imaging after injection of radiopaque Onyx® and Concerto Helix©-coils (arrows; two transvascular catheters are marked by asterisks). (c) Radiographic imaging (X-ray) of the thorax and upper abdomen after the last embolization, still existing extensive cardiomegaly.
Figure 3
Figure 3
Picture of the tibial AVM in patient 3. (a) Before EVOH embolization. (b) At follow-up.
See this image and copyright information in PMC

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