| Abstract [eng] |
Introduction. Intramuscular arteriovenous malformations are rarely encountered high-flow vascular birth defects that often present with a rather difficult angioarchitecture. Due to this, arteriovenous malformations remain amongst the most therapeutically challenging pathologies. Therefore, individual approach is required. The main treatment options are endovascular treatment and/or surgical resection. It is stated in the literature that complete surgical resection provides the best results, however the choice of treatment is determined by the feasibility of the nidus. The aim purpose of these case reports is to assess different treatment outcomes of endovascular versus combination treatment. Case descriptions. • Patient#1 have intramuscular arteriovenous malformation in the right distal 1/3 femoral region, extending to the knee joint and bone. 14 embolization procedures were performed during the period of 8 years. • Patient#2 had intramuscular arteriovenous malformation in the right gluteal-femoral region. Multi-stage approach combination treatment was planned, starting with embolization. 2days after, excision was accomplished. • Follow up examination based on symptoms, ultrasound and dynamic contrast enhanced magnetic resonance imaging uncovered that patient#2 is in complete remission. Patient#1 treated with embolization still experience symptoms. Conclusions. Patients treated with embolization alone present higher recurrence rates. Furthermore, it often requires multiple procedures to achieve clinically good outcome. In comparison, complete surgical resection with eradication of the nidus provides the best treatment results. However, due to functional muscles involvement and arteriovenous malformation infiltration into surrounding tissues it’s not always feasible. Therefore, combination treatment could be the best strategy in these cases. |
