title: Long-term results of ethanol sclerotherapy with or without adjunctive surgery for head and neck arteriovenous malformations.
abstract: BACKGROUND
  Ethanol sclerotherapy has shown favorable short-term efficacy in managing head and neck arteriovenous malformation (AVM) which is well known for high recurrence rate after treatment. The purpose of this study was to report immediate treatment results and long-term follow-up results of ethanol sclerotherapy in patients with head and neck AVMs.
  
  
  METHODS
  We performed a retrospective review of 45 patients with head and neck AVMs treated between April 1997 and December 2013 by using ethanol sclerotherapy with or without adjunctive surgery. The degree of AVM eradication was analyzed, and complications per treatment session were recorded. Long-term treatment effectiveness was assessed with clinical and imaging follow-up.
  
  
  RESULTS
  In total, 132 sclerotherapies were performed in the 45 patients, with a total angiographic eradication rate of 17.8% (n = 8). Partial resolution was achieved in 34 patients, and three patients showed no response. Mean follow-up period was 56.6 months (range, 13-144 months). The long-term recurrence rate was 11.1% (5/45), and all recurrences occurred more than 3 years after the treatment with interval disease-controlled period. The major complication rate was 3.8% (5/132), and 34 minor complications (25.8%) occurred.
  
  
  CONCLUSIONS
  Ethanol sclerotherapy is effective for achieving long-term durable cure of head and neck AVMs. In patients with non-curable disease, it is also effective for symptom palliation and long-term disease control. However, given recurrence after interval disease-controlled period, long-term follow-up should be required to detect recurrence in patients with any residual lesion after treatment.
authors.affiliation: Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Irwon-dong, Gangnam-gu, Seoul, 135-710, Republic of Korea.
authors.forename: Byungjun
authors.initials: B
authors.lastname: Kim
authors.forename: Keonha
authors.initials: K
authors.lastname: Kim
authors.forename: Pyoung
authors.initials: P
authors.lastname: Jeon
authors.forename: Sungtae
authors.initials: S
authors.lastname: Kim
authors.forename: Hyungjin
authors.initials: H
authors.lastname: Kim
authors.forename: Hongsik
authors.initials: H
authors.lastname: Byun
authors.forename: Dongik
authors.initials: D
authors.lastname: Kim
authors.forename: Youngwook
authors.initials: Y
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D001165:Arteriovenous Malformations / Q000628:therapy*; D002533:Cerebral Angiography; D002648:Child; D002675:Child, Preschool; D000431:Ethanol / Q000627:therapeutic use*; D005260:Female; D006257:Head; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009333:Neck; D012008:Recurrence; D015911:Sclerotherapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000431:Ethanol