Dataset Information

Staged endovascular and open surgical approach for treatment of a giant left upper back arteriovenous malformation.

ABSTRACT: We present a case of a symptomatic, giant, left upper back arteriovenous malformation that was treated through a staged endovascular and open approach. Through a series of embolizations, followed by resection, we were able to preserve the limb and upper back neurovascular supply, demonstrating an approach to preserve sensation and function and improving quality of life.

SUBMITTER: Venkat N

PROVIDER: S-EPMC11255887 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Staged endovascular and open surgical approach for treatment of a giant left upper back arteriovenous malformation.

Venkat Nitya N Saraiya Avinash A Ali M Irfan MI Jenkins Matthew M Tjoumakaris Stavropoula S Abai Babak B

Journal of vascular surgery cases and innovative techniques 20240515 4

We present a case of a symptomatic, giant, left upper back arteriovenous malformation that was treated through a staged endovascular and open approach. Through a series of embolizations, followed by resection, we were able to preserve the limb and upper back neurovascular supply, demonstrating an approach to preserve sensation and function and improving quality of life. ...[more]

PMID: 39027724

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Project description:Rationale & objectiveTo facilitate the process of dialysis for patients with kidney failure, an arteriovenous fistula (AVF) is created using either a surgical or percutaneous approach. We sought to compare the efficacy and procedural outcomes in creating an AVF percutaneously using Ellipsys (Avenu Medical) or WavelinQ (Becton Dickinson Medical) with surgery in all patients with kidney failure requiring a permanent AVF for dialysis.Study designSystematic review and meta-analysis.Setting & study populationsAll patients requiring a permanent AVF for dialysis.Selection criteria for studiesWe included studies that compared either the Ellipsys device or WavelinQ directly with surgery to create an AVF for long-term dialysis.Data extractionTwo reviewers independently reviewed the studies and extracted the data. Conflicts were resolved with a discussion and approval from the senior author.Analytical approachFixed-effects or random-effects models were used to pool the fixed sizes and 95% CIs based on the level of heterogeneity.ResultsThere was no statistically significant difference observed between surgical AVF and endovascular AVF when comparing the primary outcomes of procedural success (OR = 1.44; 95% CI, 0.35, 5.88; P = 0.61; I2 = 0%), complications (OR = 0.28; 95% CI, 0.06, 1.46; P = 0.13; I2 = 69%), and the secondary outcomes of interest that included follow-up time (mean difference [MD] = -17.71; 95% CI, -189.53, 154.12; P = 0.84; I2 = 94%), failure rate (OR = 1.03; 95% CI, 0.21, 5.13; P = 0.97; I2 = 85%), and time to 2-needle cannulation (MD = -5.40; 95% CI, -38.88, 28.08; P = 0.75; I2 = 0%). However, a statistically significant difference was seen among the 2 groups for procedural time (MD = -54.25; 95% CI, -59.78, -48.71; P < 0.001; I2 = 98%), number of interventions needed to maintain patency (OR = 1.73; 95% CI, 1.22, 2.45; P < 0.01; I2 = 94%), and primary patency rate (OR = 0.34; 95% CI, 0.23,0.52; P < 0.001; I2 = 0%).LimitationsThe total number of studies included in this review was limited, with 3 of the 4 included studies being retrospective and only 1 being prospective. There was a lack of heterogeneity and randomization.ConclusionsPercutaneous fistula creation using Ellipsys or WavelinQ is a unique and safe alternative with outcomes comparable to surgery. Future studies are needed, including observational studies in current clinical practice, to evaluate the efficacy and outcomes of endovascular AVF creation in clinical populations.

Dataset Information

Staged endovascular and open surgical approach for treatment of a giant left upper back arteriovenous malformation.

Publications

Staged endovascular and open surgical approach for treatment of a giant left upper back arteriovenous malformation.

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