| Abstract [eng] |
Congenital vascular malformations are a less common pathology that remains one of the most diagnostically and therapeutically challenging diseases to treat. Arteriovenous malformations (AVMs) are congenital vascular lesions that form as developmental errors of the vascular system and are characterized by direct blood flow from an artery to a vein, therefore lack normal capillary bed. AVMs exhibit more aggressive, unpredictable and dangerous clinical behavior than other types of vascular malformations. Despite new developments in AVM treatment, results are often unsatisfactory. To this date literature debates the influence of age, gender, stage, location, form and type of AVMs on treatment strategies and outcomes For the first time in Lithuania we performed a study that investigates congenital AVMs. The aim of this study was to retrospectively evaluate our AVM diagnostic capabilities and assess the influence of gender, lesion location, form, stage, first treatment attempt and modalities on treatment outcomes. We presented a novel modified transarterial perfusion scintigraphy (TLPS) method that was used to evaluate and follow AVMs. Our goal was to assess the utility of TLPS data in regards to AVM diagnosis, treatment planning and potential to follow this difficult pathology. The results of this study showed that AVM treatment outcomes were more positive when therapy was initiated at an earlier age and lower stage, extratruncular limited lesions were treated. The worst outcomes were seen in gluteal and pelvic area lesions. Patient gender had no influence on treatment success. We also demonstrated that when possible surgical treatment is more effective compared to endovascular interventions. The newly applied TLPS method allowed to objectively evaluate AVM hemodynamics and follow treatment outcomes. This method provides with valuable guidance in choosing appropriate treatment strategies, helps to diagnose and follow complicated AVM lesions and helps to predict further disease progression. |
