ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1592077
This article is part of the Research TopicAdvances in Venous InterventionsView all 4 articles
Efficacy of Embolo/sclerotherapy in the Treatment of High-output Cardiac Failure Caused by Peripheral Arteriovenous Malformations
Provisionally accepted
- 1China-Japan Friendship Hospital, Beijing, China
- 2Clinical Laboratory, China-Japan Friendship Hospital, Beijing, Beijing Municipality, China
- 3Department of Cardiovascular Surgery, China-Japan Friendship Hospital, Beijing, China
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Purpose: This study aimed to evaluate the effectiveness and outcomes of embolo/sclerotherapy in treating Schobinger Stage IV peripheral arteriovenous malformations (pAVMs) associated with high-output cardiac failure (HOCF). Methods: Between January 2017 and December 2024, 12 patients with Schobinger Stage IV pAVMs and associated HOCF were treated with embolization using coils and sclerosing agents, including bleomycin polidocanol foam (BPF) and anhydrous ethanol. Procedural outcomes, complications, devascularization and improvements in cardiac function were evaluated during follow-up. Results: A total of 24 embolo/sclerotherapy sessions were performed on the 12 patients. Complete or over 80% devascularization of the vascular malformations was achieved in 9 patients. Echocardiographic follow-up revealed significant improvements in cardiac ejection fraction and ventricular dilatation. Additionally, 8 patients showed improvement in heart valve regurgitation. For all patients, the symptom of dyspnea disappeared after embolization and no serious complications occurred. LVEF improvement showed a significant positive correlation with a decrease in venous drainage pressure of the nidus after surgery (P < 0.001) in 11 patients, while one patient was excluded due to an increase in venous drainage post-surgery.This study provides evidence that embolo/sclerotherapy effectively treats pAVMs with associated HOCF by reducing abnormal blood flow and significantly improving symptoms. The results also reveal a linear relationship between the decrease in venous drainage pressure and improvement in LVEF in patients with HOCF caused by pAVMs after embolo/sclerotherapy.
Keywords: Peripheral Arteriovenous Malformations, High-output cardiac failure, Embolo/sclerotherapy, Devascularization, Pressure of venous drainage
Received: 27 Mar 2025; Accepted: 18 Aug 2025.
Copyright: © 2025 Guo, Nie, Zheng, Ni, Yang, Ye, Liu and Fan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xixi Guo, China-Japan Friendship Hospital, Beijing, China
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