Multidisciplinary Approach for Treatment of Complicated Neck and Shoulder Peripheral Fast Flow Arteriovenous Malformation: Case Report

Activity: Talk or presentation types › Poster presentation

Description

Arteriovenous malformations are abnormal fistulas between arteries and veins without an intervening capillary bed. The peripheral arteriovenous malformations divide into slow, fast and mixed flows. Invasive treatment of arteriovenous malformations may include endovascular embolization, surgical resection, and focal beam radiation, alone or in any combination. In this case report we present fast flow arteriovenous malformation, it has large afferent arteries, which were detected on angiography.. A patient presents with a wide 18 x13 x 11,5 cm arteriovenous malformation around the neck, right shoulder, and right armpit. Several endovascular embolizations were performed with vascular trackers (coil). Recurrence was observed. Flow is restored from collateral branches that develop from the thoracic aorta. At the age of sixteen combined therapy was performed (embolization with subsequent extirpation) 48h after embolization. Extirpation was performed and neurolysis for nervus accessorius, nervus cutaneus brachii lateralis and plexus brachialis C5, C6, C7, C8, Th1 are done, and nerves are spared. The main blood vessels are spared. The wound is closed using a flap that consists of skin island and m.trapezius. During the surgery, blood loss was 2.5 l and 800 ml was recovered with a cell saver. Postoperative period in the intensive care unit, hemodynamics was maintained with vasopressors. . Patient postoperative innervation of the right upper limb and motility without abnormal findings.. Congenital arteriovenous malformations can be difficult to treat, because of extensive bleeding, and nerves can be injured during surgery which can lead to loss of function. It is noted that there is a risk of recurrence with incomplete extirpation. Extirpation of the arteriovenous malformations is technically challenging and can be life-threatening therefore embolization can prevent extreme haemorrhage.
Period29 Mar 2023
Event titleRSU International Research Conference 2023: Knowledge for Use in Practice
Event typeConference
OrganiserRīga Stradiņš University
LocationRiga, LatviaShow on map
Degree of RecognitionInternational

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