Intramuscular low flow vascular malformations: treatment by means of direct percutaneous embolization.
OBJECTIVE
Intramuscular hemodynamically inactive vascular malformations are infrequent entities whose surgical treatment is often impossible, crippling, or inefficient. We describe a nonsurgical therapeutic approach consisting on embolization by direct puncture with sclerosant substances.


METHODS
Four patients have been treated from April to November 1994, three female and one male, ranging in age from 13 to 31 years. Three vascular malformations were located in the quadriceps and one in the deltoid muscle. The point of access was determined with information provided by MR. The skin was cleaned with an antiseptic solution and puncture was performed with a 22 gauge Chiva needle. Blood flow inside the malformation was slow in all cases and no afference to the normal venous system was detected. We embolized with 5-15 cc (mean 7.5 cc) of a mixture of ethibloc and ethanol.


RESULTS
The mean follow-up period was 17 months (range 14-21). All patients remain asymptomatic and have resumed normal daily life activities. There were no complications.


CONCLUSIONS
Percutaneous embolization by direct puncture of intramuscular vascular malformations is a feasible and simple procedure. Our preliminary results are promising, although more extensive studies need to be to performed in order to reach definite conclusions.
Górriz
E
E
Unidad de Radiología Vascular Intervencionista, Hospital Universitario NTRA, SRA, Del Pino, Universidad de Las Palmas de Gran Canaria, Spain.
Carreira
J M
JM
Reyes
R
R
Gervás
C
C
Pulido
J M
JM
Pardo
M D
MD
Maynar
M
M
D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000628:therapy*; D003973:Diatrizoate / Q000627:therapeutic use; D004338:Drug Combinations; D004621:Embolization, Therapeutic; D000431:Ethanol / Q000627:therapeutic use; D005227:Fatty Acids / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000098:blood supply; D011409:Propylene Glycols / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000627:therapeutic use; D012997:Solvents / Q000627:therapeutic use; D013997:Time Factors; D015028:Zein / Q000627:therapeutic use
D004338:Drug Combinations; D005227:Fatty Acids; D011409:Propylene Glycols; D012597:Sclerosing Solutions; D012997:Solvents; D003973:Diatrizoate; D000431:Ethanol; D015028:Zein; C020481:alcoholic prolamine solution