Journal of Tissue Engineering and Reconstructive Surgery ›› 2024, Vol. 20 ›› Issue (4): 440-.

Previous Articles     Next Articles

Surgical management of soft tissue arteriovenous malformations:A retrospective study in one center

  

  • Online:2024-08-01 Published:2024-09-11

Abstract:

Objective  To evaluate the surgical management of patients with soft tissue arteriovenous malformations.Methods Data of 43 AVM patients who underwent surgical treatment in our department from January 2007 to December 2022 were retrospectively analyzed, including 23 males and 20 females, aged 8-62 years, with an average age of 27.3 years. The lesion sites included head and neck( n=29), trunk( n=5), upper limbs( n=4) and lower limbs( n=5). The situation of these patients was evaluated according to the Schobinger staging system and Yakes classification. The strategy of surgical management was summarized based on the methods and outcomes of the above cases. Results A total of 43 patients were included in the study. According to the Schobinger staging system, there were 8 stage Ⅰ, 21 stage Ⅱ, 13 stage Ⅲ and 1 stage Ⅳ patients. Based on the Yakes classification, the lesions included 5 Yakes type Ⅰ, 13 type Ⅱ, 7 type Ⅲ, and 17 type Ⅳ. One of the patients could not be classified with Yakes classification due to lack of vascular imaging results. Simple surgical resection was performed in 29 patients, combined preoperative superselective embolization with surgical resection was performed in 5 patients, two-stage surgical resection with application of tissue expanders was performed in 6 patients, amputation was performed in 3 patients. As for wound repair, primary linear closure was performed in 14 patients, skin grafting in 15 patients, expanded flaps in 6 patients, and local flaps in 8 patients. The incisions healed primarily. Skin grafts and flaps survived well. During the follow-up of 6-112 months( 33.7 months on average), 37 patients were cured( 84%) and 6 improved. Conclusion  Based on the site, anatomy, clinical staging and Yakes classification, combined with interventional embolization and expanders, personalized surgical treatment can obtain satisfactory short-term and long-term results.

Key words: Arteriovenous malformations,  Surgical management,  Interventional embolism,  Expander