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Embolization Techniques for Arteriovenous Malformations in Parkes-Weber Syndrome
Allan M Conway1, Khalil Qato1, Nhan T Nguyen Tran1
1Department of Surgery, Lenox Hill Hospital, Northwell Health System, New York, NY.
Annals of Vascular Surgery
|June 2, 2020
Summary
Transcatheter embolization is an effective treatment for Parkes-Weber syndrome (PWS) arteriovenous malformations (AVMs), often requiring multiple procedures. Patients with severe wounds face limb loss risks despite treatment.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Dermatology
Background:
- Parkes-Weber syndrome (PWS) is characterized by high-flow arteriovenous malformations (AVMs).
- Surgical resection historically yields poor outcomes in PWS management.
- Current management strategies for PWS require reassessment.
Purpose of the Study:
- To evaluate the efficacy of transcatheter embolization for PWS.
- To assess outcomes and complications associated with PWS treatment.
- To identify risk factors for adverse outcomes in PWS patients.
Main Methods:
- Retrospective review of 14 PWS patients from 2004-2017.
- Analysis of patient presentation, treatment techniques, and outcomes.
- All patients underwent diagnostic angiography; 11 received transcatheter embolization.
Main Results:
- Transcatheter embolization achieved technical success in all treated patients.
- 55% required multiple embolization procedures (mean 3.3 interventions).
- Partial response observed in 91% of patients; 2 patients with extensive wounds underwent amputation.
Conclusions:
- Transcatheter embolization is a viable treatment for PWS AVMs.
- Multiple embolization sessions are typically necessary for effective management.
- Extensive wounds in PWS patients increase the risk of limb loss.
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