Sepand Salehian BS, Presenter: Nothing to Disclose

Suresh K. Mukherji MD, Abstract Co-Author: Consultant, Koninklijke Philips Electronics NV Consultant, General Electric Company

Joseph J. Gemmete MD, Abstract Co-Author: Nothing to Disclose

Imaging can be used to distinguish between high-flow and low-flow vascular lesions. Little information exists regarding the differences in treatment outcome between low-flow and high-flow lesions. In this retrospective study, we analyze treatment and outcomes of patients with craniofacial vascular abnormalities.

Twenty-eight patients (11 men and 17 women, mean age 27 years) had imaging findings consistent with craniofacial vascular abnormalities: 8 arteriovenous malformations (AVM), 4 hemangiomas, 9 venous malformations, 5 lymphangiomas, 1 capillary malformation, and 1 venous-capillary malformations. Endothelial lesions were analyzed for the following factors: treatment, outcome, and complications.

Patients with high flow lesions (AVMs) underwent an average of 4.1 procedures versus 1.9 procedures for low flow lesions (non-infantile hemangiomas, venous malformations, lymphangiomas, capillary malformation, and mixed lesions). All high flow lesions were treated with endovascular embolization. One patient was unable to undergo endovascular embolization or sclerotherapy out of concern for the lesion’s proximity to intracranial circulation. Ninety percent of low flow lesions were treated with sclerotherapy; only 10% of low flow lesions were treated with endovascular embolization. Complete obliteration of high flow lesions was obtained in 62% of cases; in contrast, complete obliteration of low flow lesions was obtained in 75% of cases. Unsuccessful outcomes, defined as incomplete obliteration, were more predominant in patients with older age (35.12 vs. 23.85 years) and female gender (35% female vs. 18% male). Untoward complications in this study included profuse bleeding from the mandible, inadequate pain control following sclerotherapy with ethanol, and fibrous scar tissue formation. No neurological complications were experienced.

Our results suggest that imaging findings can be used to predict success of various treatment modalities for craniofacial vascular abnormalities. High flow lesions require multiple procedures for complete ablation. Low flow lesions require fewer procedures, and are generally treated with sclerotherapy with a higher rate of success.

There is little data regarding treatment modality/outcomes of craniofacial vascular abnormalities in adults and children. This study analyzes 8 years of experience at the University of Michigan.

Salehian, S, Mukherji, S, Gemmete, J, Eight-year Single Institutional Experience with Craniofacial Vascular Abnormalities at the University of Michigan.  Radiological Society of North America 2009 Scientific Assembly and Annual Meeting, November 29 - December 4, 2009 ,Chicago IL. http://archive.rsna.org/2009/8004847.html