Journal «Angiology and Vascular Surgery» • 

2015 • VOLUME 21 • №3

Combined treatment of complicated forms of angiodysplasias in conditions of a multimodality hospital

Soroka V.V., Borovsky I.E., Khomchuk I.A., Ovcharenko D.V., Magamedov I.D.

Vascular Surgery Department, Scientific Research Institute for Emergency Ambulance Care named after I.I. Dzhanelidze, St. Petersburg, Russia

Presented herein is a case report dealing with successive combined treatment for arteriovenous malformation of the left part of the chest, macrofistular form complicated by necroses of the left thoracic portion with arrosive haemorrhage from the area of necrosis. The authors describe diagnosis of this disease, technical peculiarities of performing transcatheter endovascular occlusion and topical treatment of wounds, underlining difficulties of verifying the pathology concerned at the prehospital stage and prevention of complications. Particular emphasis in management of these patients is placed upon therapeutic decision-making. Radical excision of tissue practically completely consisting of dilated thin-walled vessels may result in massive perfuse haemorrhage and is often impossible. Selective exclusion of feeding arteries by endovascular methods frequently leads to formation of necroses, does not differ in radical nature because of the presence of multiple arteriovenous fistulas and requires regular follow up of the patient due to a possibility of relapse. The final therapeutic decision should be made in the context of a particular patient, since there are no versatile approaches to management of the pathology concerned.

KEY WORDS: congenital arteriovenous angiodysplasia, arteriovenous malformation, roentgen endovascular occlusion, necrectomy.

P. 128

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