AUTHOR=Shen Yuchen , Han Qianyun , Wang Deming , Su Lixin , Wen Mingzhe , Fan Xindong , Yang Xitao 

TITLE=Coil-assisted ethanol embolization of traumatic arteriovenous fistulas: a 10-year retrospective study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 11 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2024.1449480

DOI=10.3389/fcvm.2024.1449480

ISSN=2297-055X

ABSTRACT=This study aimed to evaluate the efficacy and safety of ethanol embolization in treating traumatic arteriovenous fistulas (TAVFs).From March 2012 to April 2020, 42 consecutive patients (29.9±15.1 years, range: 3-68 years) with peripheral TAVFs underwent ethanol embolization. All patients underwent clinical and imaging follow-up (40.0±25.9 months, 3-90 months). The mean time to onset of symptoms after trauma was 5.4±5.9 months (range: 0.5-30 months). In total, 27 (64.3%) reported that the TAVFs were presented after blunt trauma, 10 (23.8%) were shown after penetrating trauma (4 patients were penetrated with infusion indwelling needles), and 3 (7.1%) had surgery history. Treatment effects, devascularization rate, and complications were evaluated at follow-ups at 1-3 months intervals.Results: Seventy-one embolization procedures were conducted, with a mean of 1.6±0.7 procedures per patient. Thirty-four patients received coil-assisted ethanol embolization;Absolute ethanol was administered in all procedures, with an average volume of 7.1±4.2mL per procedure (range: 1-18 mL); 28 patients (28/42, 66.7%) received coil embolization in 36 procedures (36/71, 50.7%). In reexamination, 39 patients (92.9%) achieved 100% devascularization; 29 out of 39 patients (74.4%) with Schobinger Stage II TAVFs had improved to Stage I or asymptomatic. Finally, 30 cases (66.7%) achieved complete response, and the other 12 (33.3%) showed partial response. Besides, apart from minor complications, no major complications were observed postoperatively.Coil-assisted ethanol embolization can effectively manage TAVFs with 4 an acceptable risk of mild complications.