الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Vascular malformations can be classified according to endothelial characteristics and flow dynamics of the lesions, on which the principles of treatment are based. Percutaneous injection of sclerosing agents such as ethanol or sodium tetradecyl sulfate is the mainstay treatment for the more prevalent low-flow or venous vascular malformations. In contrast, symptomatic high-flow AVM generally require transcatheter embolosclerotherapy with or without surgery to control the disease process. Because of the rarity of high flow AVMs, there is a relative paucity of data regarding the natural history of the condition and long-term outcomes after conservative treatment, embolosclerotherapy, or surgery. This study was conducted at Mansoura University Hospitals aiming to evaluate the safety and efficacy of endovascular management of high flow arteriovenous malformation by embolization and sclerotherapy. We included a total of 18 cases diagnosed with high flow AVM. All cases were subjected to complete history taking, thorough physical examination, and routine laboratory investigations. Also, duplex US and CT angiography were ordered for all cases. Our results showed that: • The mean age of the included cases was (26.73 years (range, 8 – 60 years). • Males represented 61.11% of these cases, while the remaining patients were females. • Regarding the site of AVM, left mandible was affected in 3 cases (20%), while rt hand was affected in the same number of cases. Other sites included lower lip, lower lip and right mandible, right mandible, right ear and mandible, posterior neck triangle, right cheek, right lumbar region, right and left foot. • Painful swelling was reported by all cases, whereas bleeding was experienced in 8 cases (44.44%). Ten cases complained of disfigurement caused by the lesion (55.56%). • Ten cases (55.56%) had stage II, while the remaining eight cases had stage III (44.44%). • Eleven cases had no previous interventions for their AVM. On the other hand, four cases had previous surgical intervention (22.22%), while embolization was performed in two cases (11.11%). Only one case had both surgery and embolization (5.56%). • Thirteen cases had only one embolization session, (72.22%) whereas the four cases had two sessions (22.22%). and one case had three sessions (5.56%). • Onyx ampoules (type 18 – 1.5 ml) were used in 12 cases (66.67%). Together with Onyx, alcohol was injected in 12 cases either locally or trans catheter (66.67%), while alcohol was used along with coil embolization in 3 cases (16.67%). Combined alcohol and histoacryl injection were performed in 3 cases (16.67%). • Complete obliteration of nidus was achieved in most cases (88.89%), while only one case had incomplete obliteration. • As regard the clinical result, success was achieved in 16 cases (61.11%). Only two cases had poor clinical result (11.11%). • Transient ischemia was encountered in 2 cases (11.11%). Other complications included ulceration (5.56%), foot gangrene (5.56%), hand ischemia with amputation (5.56%), contracture scar (5.56%), and necrosis with transient PE (6.7%). • With a mean follow up period of 26 months (range, 6 – 36 months), 16 cases showed very good outcome (88.89%), while the remaining two cases had poor outcome (11.11%).