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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Vascular embolization combined with amputation for recurrent hemophilic pseudotumor
Shuaijie Lv1,2, Lei Chen1, Yi Tang1
1The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), 54 Youdian Road, Shangcheng District, Hangzhou City, Zhejiang Province, China.
Hemophilic pseudotumor is a rare, life - threatening complication of hemophilia. Surgical treatment presents substantial challenges, particularly in coagulation management, perioperative wound healing, and infection control. We present a case of recurrent pseudotumor with refractory wound healing following multiple surgical interventions, which was successfully managed through a multidisciplinary approach combining vascular embolization with amputation. The case involves a 28-year-old male patient with hemophilia-associated pseudotumor who presented with a two-year history of impaired wound healing following right above-knee amputation. Clinical examination revealed significant swelling and tenderness in the right thigh region, accompanied by persistent drainage of black viscous exudate from the surgical site. Due to pseudotumor recurrence and chronic wound complications, a multidisciplinary team comprising hematology, interventional radiology, and orthopedic specialists implemented a combined therapeutic strategy of preoperative vascular embolization followed by definitive amputation. The postoperative course demonstrated favorable outcomes, with complete wound healing and no evidence of disease recurrence during the 6-month follow-up observation period.
Hemophilic pseudotumor is a rare, life - threatening complication of hemophilia. Surgical treatment presents substantial challenges, particularly in coagulation management, perioperative wound healing, and infection control. We present a case of recurrent pseudotumor with refractory wound healing following multiple surgical interventions, which was successfully managed through a multidisciplinary approach combining vascular embolization with amputation. The case involves a 28-year-old male patient with hemophilia-associated pseudotumor who presented with a two-year history of impaired wound healing following right above-knee amputation. Clinical examination revealed significant swelling and tenderness in the right thigh region, accompanied by persistent drainage of black viscous exudate from the surgical site. Due to pseudotumor recurrence and chronic wound complications, a multidisciplinary team comprising hematology, interventional radiology, and orthopedic specialists implemented a combined therapeutic strategy of preoperative vascular embolization followed by definitive amputation. The postoperative course demonstrated favorable outcomes, with complete wound healing and no evidence of disease recurrence during the 6-month follow-up observation period.
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