Auricular arteriovenous malformations: potential success of superselective ethanol embolotherapy

To assess retrospectively the effectiveness and safety of superselective ethanol embolotherapy for auricular arteriovenous malformations (AVMs).

Ethanol embolizations were performed under fluoroscopy by direct puncture techniques in eight patients (five male) with auricular AVMs from June 2006 to April 2008. The mean age of the patients was 31.5 years (age range, 10-59 y). Clinical follow-up (range, 5-27 months; mean, 12.6 months) and digital subtraction angiography follow-up (range, 4-25 months; mean, 8.0 months) were performed in all patients. Therapeutic outcomes were established by evaluating the outcome of symptoms and aesthetic appearance, as well as the degree of devascularization at follow-up angiography.

Fifteen embolotherapy procedures were performed in eight patients. Six patients (75.0%) experienced complete resolution of abnormal angioarchitecture and were rated as cured at follow-up angiography. Complete control of bleeding, ulceration, and pruritus was achieved in all five patients with these symptoms (100%). In terms of aesthetic results, five patients (62.5%) showed complete resolution of the masses and were rated as cured. One patient (12.5%) experienced superficial skin necrosis that healed spontaneously after 4 weeks, without ear defect. Even though all the patients experienced blistering immediately after treatment, the complications were self-limited and minor. There were no major complications.

In a limited series, superselective ethanol embolotherapy was effective and safe in the treatment of auricular AVMs.