Abstract：
BACKGROUND: Scalp arteriovenous malformations (AVMs), or cirsoid aneurysms of the scalp, usually present with troublesome symptoms and cosmetic disfigurement. Endovascular/percutaneous embolization has evolved as a sole treatment method or adjunct to surgical excision in the management of scalp AVMs with an excellent outcome.
OBJECTIVE: To discuss minimally invasive techniques for treating scalp AVMs as well as to highlight the role of embolization before surgery.
METHODS: This is a retrospective study of 50 patients with scalp AVM who underwent embolization (percutaneous/endovascular) during 2010-2019 at a tertiary care center. n-butyl cyanoacrylate (n-BCA) was used as an embolizing agent in all the cases and the patients were followed up at three- and six-month intervals with Doppler evaluation.
RESULTS: A total of 50 patients were included in the study. The occipital region was the most common location; 82% were Schobinger class II lesions and 18% were class III lesions. Thirteen patients had small-sized AVMs and 37 patients had large-sized AVMs. Post-embolization surgery was performed in 36 patients. Of the patients, 28 underwent percutaneous embolization, 20 underwent endovascular embolization, and two underwent both to achieve complete embolization of the lesion. The number of percutaneous procedures increased in the latter half of the study period as the safety and efficacy of the technique were established. No major complications were seen in this study.
CONCLUSIONS: Embolization of scalp AVMs is a safe and effective technique and can be used in isolation for small lesions and as an adjunct procedure to surgery for large-sized lesions.
OBJECTIVE: To discuss minimally invasive techniques for treating scalp AVMs as well as to highlight the role of embolization before surgery.
METHODS: This is a retrospective study of 50 patients with scalp AVM who underwent embolization (percutaneous/endovascular) during 2010-2019 at a tertiary care center. n-butyl cyanoacrylate (n-BCA) was used as an embolizing agent in all the cases and the patients were followed up at three- and six-month intervals with Doppler evaluation.
RESULTS: A total of 50 patients were included in the study. The occipital region was the most common location; 82% were Schobinger class II lesions and 18% were class III lesions. Thirteen patients had small-sized AVMs and 37 patients had large-sized AVMs. Post-embolization surgery was performed in 36 patients. Of the patients, 28 underwent percutaneous embolization, 20 underwent endovascular embolization, and two underwent both to achieve complete embolization of the lesion. The number of percutaneous procedures increased in the latter half of the study period as the safety and efficacy of the technique were established. No major complications were seen in this study.
CONCLUSIONS: Embolization of scalp AVMs is a safe and effective technique and can be used in isolation for small lesions and as an adjunct procedure to surgery for large-sized lesions.
摘要：
背景：头皮动静脉畸形（AVM），或者头皮的环状动脉瘤，通常表现为麻烦的症状和美容毁容。血管内/经皮栓塞已发展成为治疗头皮AVM的唯一治疗方法或手术切除的辅助手段，效果良好。
目的：探讨头皮AVM的微创治疗技术，并强调术前栓塞的作用。
方法：这是一项对50例头皮AVM患者的回顾性研究，这些患者在2010-2019年期间在三级护理中心接受了栓塞（经皮/血管内）。在所有病例中，氰基丙烯酸正丁酯（n-BCA）均用作栓塞剂，并对患者进行了3个月和6个月的随访，并进行了多普勒评估。
结果：本研究共纳入50例患者。枕骨区是最常见的位置；82％为SchobingerII类病变，18％为III类病变。13例患者患有小尺寸AVM，37例患者患有大尺寸AVM。栓塞后手术36例。在患者中，28例接受经皮栓塞，20例血管内栓塞,两个人都接受了完全栓塞的病变。随着该技术的安全性和有效性的确立，在研究期间的后半期，经皮手术的数量增加。在这项研究中没有看到严重的并发症。
结论：头皮AVM栓塞是一种安全有效的技术，可单独用于小病灶，也可作为大尺寸病灶手术的辅助手术。
目的：探讨头皮AVM的微创治疗技术，并强调术前栓塞的作用。
方法：这是一项对50例头皮AVM患者的回顾性研究，这些患者在2010-2019年期间在三级护理中心接受了栓塞（经皮/血管内）。在所有病例中，氰基丙烯酸正丁酯（n-BCA）均用作栓塞剂，并对患者进行了3个月和6个月的随访，并进行了多普勒评估。
结果：本研究共纳入50例患者。枕骨区是最常见的位置；82％为SchobingerII类病变，18％为III类病变。13例患者患有小尺寸AVM，37例患者患有大尺寸AVM。栓塞后手术36例。在患者中，28例接受经皮栓塞，20例血管内栓塞,两个人都接受了完全栓塞的病变。随着该技术的安全性和有效性的确立，在研究期间的后半期，经皮手术的数量增加。在这项研究中没有看到严重的并发症。
结论：头皮AVM栓塞是一种安全有效的技术，可单独用于小病灶，也可作为大尺寸病灶手术的辅助手术。
