Wayne Francis Yakes MD, Presenter: Nothing to Disclose

AVM of bone is a difficult management problem. Because standard embolic agents are rarely curative and only palliative, ethanol and ethanol with coils are evaluated to curatively treat bone AVMs as an alternative management strategy.

Twenty-nine patients (17 f, 12 m); age range 6 – 48 years, mean: 19 years) presented with bone AVMs involving the upper extremity, lower extremity, pelvis, spine, and head and neck areas. All patients underwent MR, arteriography, and endovascular repair of their bone AVMs. Ethanol alone, ethanol with coils, and coils were the sole embolic agents utilized.              

Twenty-eight of twenty-nine patients are cured of their intraosseous AVM at follow-up (range 8 months – 168 months; mean: 54 months). One patient’s therapy is on-going (mandible/maxilla/face AVMs). Complications include one coil migration to the lung (retrieved without sequelae), three patients with skin injury in the lower extremity (healed uneventfully), and one patient with chronic weakness left quadriceps femoris muscle group, which was present prior to treatment and not improved with treatment of her pelvic/iliac wing AVM. One patient had a right maxilla infection/sinusitis treated by antibiotics.                

Bone AVMs in the literature are rarely cured, save by amputation. Ethanol or ethanol with coils has proven to be consistent in ablating bone AVMs and are durable at long-term follow-up, in essence curing the AVM. When bone AVM is present in an extremity, multiple AVMs in that extremity can occur, an unexpected finding. Acceptable low complication rates are noted in this series.  

AVM of bone is a difficult management problem. Because standard embolic agents (glue, PVA, Onyx, Embospheres, etc.) are rarely curative and only palliative, ethanol and ethanol with coils are evaluated to curatively treat bone AVMs as an alternative management strategy.    

Yakes, W, Embolization of Intraosseous AVM.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015082.html