Summary Torrential bleeding of arteriovenous malformation A case report joe-h-personal-sharing-drive.s3.amazonaws.com
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A case report highlights successful treatment for torrential bleeding that can occur during ethanol sclerotherapy for AVMs.
Slides
Slide Presentation (9 slides)
Key Points
- Embolization or sclerotherapy is the first-line therapy for arteriovenous malformations (AVMs).
- Ethanol is an effective embolic agent for AVM treatment, but complications can arise.
- This case report presents a case of torrential bleeding following ethanol sclerotherapy in a patient with hand AVM.
- Direct pressure, tourniquet appliance, and split-thickness skin graft procedure were performed to stop the bleeding successfully.
- Ethanol sclerotherapy can provide complete alleviation of pain in AVM patients.
Summaries
17 word summary
Complications can occur during ethanol sclerotherapy for AVMs. A case report discusses successful treatment for torrential bleeding.
61 word summary
Embolization with ethanol is the preferred treatment for arteriovenous malformations (AVMs), but complications can occur. This case report discusses a patient with hand AVMs who experienced torrential bleeding during ethanol sclerotherapy. The bleeding was successfully stopped using direct pressure, tourniquet application, and a skin graft procedure. Prompt treatment is necessary for AVM hemorrhage, and multimodality approaches can effectively manage high-flow hemorrhage.
149 word summary
Embolization is the preferred treatment for arteriovenous malformations (AVMs) using ethanol as an embolic agent. However, complications can occur, including major ones like limb amputation and cardiovascular collapse. In this case report, a patient with hand AVMs underwent ethanol sclerotherapy, resulting in torrential bleeding. The bleeding was successfully stopped using direct pressure, tourniquet application, and a split-thickness skin graft procedure. The patient experienced complete pain relief and no recurrence of bleeding. AVMs are difficult to detect early on and can lead to weakened vascular walls and a higher risk of hemorrhage. Ethanol sclerotherapy is commonly used but can cause complications. Prompt treatment is necessary for AVM hemorrhage, and in this case, emergency intervention successfully stopped the bleeding. Ethanol sclerotherapy can provide clinical benefits in pain relief, but proper pressure application is essential. Additional treatment may be required for AVMs, and multimodality approaches can be successful in managing high-flow hemorrhage.
379 word summary
Embolization is the preferred treatment for arteriovenous malformations (AVMs) and ethanol is an effective embolic agent. However, complications from ethanol sclerotherapy can occur, including major complications such as limb amputation and cardiovascular collapse. In this case report, a patient with hand AVMs underwent ethanol sclerotherapy, resulting in torrential bleeding. The bleeding was successfully stopped using direct pressure, tourniquet application, and a split-thickness skin graft procedure. The patient experienced complete pain relief and no recurrence of bleeding.
The patient was a 27-year-old male with a mass on his right palm that had been developing for 20 years. The mass had rapidly progressed over the past year and was causing severe pain. Imaging studies confirmed the presence of AVMs in the hand. Ethanol sclerotherapy initially devascularized the AVMs and reduced pain. However, spontaneous bleeding occurred in the distal fourth finger after the procedure, requiring immediate intervention.
A second sclerotherapy procedure was performed a month later, but multiple bullae appeared at the injection sites. The patient reported complete pain relief following this procedure. However, three weeks later, torrential bleeding occurred at the same site during guided sclerotherapy. The bleeding was continuous and unresolved with direct pressure but was successfully managed with pressure dressing and temporary tourniquet application. The patient's hand was scheduled for amputation, but further evaluation showed a decrease in the size of the AVM nidi. Split-thickness skin grafting was performed to cover the granulation tissue and prevent further bleeding complications.
AVMs can occur anywhere in the body and are difficult to detect early on. They can lead to weakened vascular walls and a higher risk of hemorrhage. Ethanol sclerotherapy is commonly used to treat AVMs but can cause complications such as vascular necrosis and unintended tissue infarctions. Hemorrhage can occur naturally or as a post-treatment complication. Prompt treatment is necessary for AVM hemorrhage, and in this case, emergency intervention successfully stopped the bleeding.
In conclusion, this case report demonstrates the potential for high-flow hemorrhage following ethanol sclerotherapy for AVMs. Prompt intervention using tourniquets, direct pressure, and elastic bandages can effectively manage emergency bleeding. Ethanol sclerotherapy can provide clinical benefits in pain relief, but proper pressure application is essential to manage potential side effects. Additional treatment may be required for AVMs, and multimodality approaches can be successful in managing high-flow hemorrhage.
463 word summary
Embolization is the preferred treatment for arteriovenous malformations (AVMs), with ethanol being an effective embolic agent. Complications from ethanol sclerotherapy are rare, but can include major complications such as limb amputation and cardiovascular collapse. In this case report, a patient with progressive hand AVMs underwent ethanol sclerotherapy, which resulted in torrential bleeding. Measures were taken to successfully stop the bleeding, including direct pressure, tourniquet application, and a split-thickness skin graft procedure. The patient experienced complete alleviation of pain and no recurrence of bleeding.
The patient in this case was a 27-year-old male with a mass on his right palm that had been developing for 20 years. The mass had progressed rapidly over the past year and was causing severe pain. The patient had a history of surgical mass removal, but the mass grew back in size accompanied by pain. Imaging studies confirmed the presence of AVMs in the hand. The patient underwent ethanol sclerotherapy, which initially resulted in devascularization of the AVMs and significant reduction in pain. However, spontaneous bleeding occurred in the distal fourth finger after the procedure and required immediate intervention to stop the bleeding.
A second sclerotherapy procedure was performed a month later, but multiple bullae appeared at the injection sites afterwards. The patient reported complete alleviation of pain following this procedure. However, three weeks later, the patient experienced torrential bleeding at the same site as the previous vein varix during guided sclerotherapy. The bleeding was continuous and unresolved with direct pressure, but was successfully managed with pressure dressing and the temporary application of a tourniquet. The patient's hand was scheduled for amputation, but further evaluation showed that the AVM nidi had decreased in size. The patient underwent split-thickness skin grafting to cover the granulation tissue and prevent further bleeding complications.
AVMs can occur in any part of the body and are often difficult to detect in the early stages. The natural progression of AVMs can lead to weakened vascular walls and a higher risk of hemorrhage. Ethanol sclerotherapy is commonly used to treat AVMs, but it can cause complications such as transmural vascular necrosis and unintended tissue infarctions. Hemorrhage can occur due to the natural progression of the AVM or as a posttreatment complication. Prompt treatment is necessary for hemorrhage in AVMs, and in this case, emergency intervention was successful in stopping the bleeding.
In conclusion, this case report highlights the potential for high flow hemorrhage following ethanol sclerotherapy for AVMs. Prompt intervention with tourniquet use, direct pressure, and constant pressure with elastic bandages can be effective in managing emergency bleeding. Ethanol sclerotherapy can provide clinical benefits in alleviating pain, but proper pressure application is necessary to manage potential side effects. Further treatment may be required for AVMs, but multimodality approaches can be successful in managing high flow hemorrhage.