title: Extremity arteriovenous malformations involving the bone: therapeutic outcomes of ethanol embolotherapy.
abstract: OBJECTIVE
  To assess retrospectively the therapeutic results, complications, and therapeutic approach to ethanol embolotherapy of extremity arteriovenous malformations (AVMs) involving the bone.
  
  
  METHODS
  From December 1996 to May 2009, 22 patients (12 male, 10 female; eight children, 14 adults; age range, 1-64 years) with extremity AVMs involving the bone underwent staged ethanol embolotherapy (range, 1-12 procedures; mean, 4.4 procedures) under general anesthesia. Four patients had pure bone AVMs and 18 had mixed bone and soft-tissue AVMs. Pulmonary artery pressure and arterial blood pressure were monitored as ethanol was injected. Ethanol embolotherapy was performed by direct puncture and/or transcatheter approach. Therapeutic outcomes were established by evaluation of the clinical response of symptoms and signs, as well as the degree of devascularization at follow-up angiography or computed tomography.
  
  
  RESULTS
  Ninety-six ethanol embolotherapy procedures were performed in 22 patients. Four (18%) were cured, 14 (64%) showed improvement, three (14%) showed no change, and one (4%) experienced treatment failure and amputation of the affected extremity. Ethanol embolotherapy was considered effective (ie, combined cure and improvement outcomes) in 18 patients (82%). Ten patients (45%) experienced complications. Twelve minor complications (skin and transient peripheral nerve injury; 13%) and one major complications (longstanding nerve palsy; 1%) occurred in 96 procedures.
  
  
  CONCLUSIONS
  Ethanol embolotherapy of extremity AVMs involving the bone has the potential to eliminate or improve symptoms in a high percentage of patients, with an acceptable risk of minor and major complications.
authors.affiliation: Department of Radiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Kangnam-gu, Seoul 135-710, Korea. ysdo@skku.edu
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Do
authors.forename: Kwang Bo
authors.initials: KB
authors.lastname: Park
authors.forename: Hong Suk
authors.initials: HS
authors.lastname: Park
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Cho
authors.forename: Sung Wook
authors.initials: SW
authors.lastname: Shin
authors.forename: Jung Won
authors.initials: JW
authors.lastname: Moon
authors.forename: Dong-Ik
authors.initials: DI
authors.lastname: Kim
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Kim
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Chang
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Hee Youn
authors.initials: HY
authors.lastname: Hwang
authors.forename: Ji Hye
authors.initials: JH
authors.lastname: Hwang
authors.forename: In-Wook
authors.initials: IW
authors.lastname: Choo
mesh_terms: D000293:Adolescent; D000328:Adult; D001165:Arteriovenous Malformations / Q000628:therapy*; D001842:Bone and Bones / Q000002:abnormalities* / Q000098:blood supply* / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005121:Extremities / Q000098:blood supply*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012597:Sclerosing Solutions / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012597:Sclerosing Solutions