INTRAMUSCULAR LOW-FLOW VASCULAR MALFORMATIONS - TREATMENT BY MEANS OFDIRECT PERCUTANEOUS EMBOLIZATION

Purpose: Intramuscular hemodynamically inactive Vascular malformations are infrequent entities whose surgical treatment is often impossible, crippling, or inefficient. We describe a nonsurgical therapeutic appr oach consisting on embolization by direct puncture with sclerosant sub stances. Methods: Four patients have been treated from April to Novemb er 1994, three female and one male, ranging in age from 13 to 31 years . Three vascular malformations were located in the quadriceps and one in the deltoid muscle. The point of access was determined with informa tion provided by MR. The skin was cleaned with an antiseptic solution and puncture was performed with a 22 gauge Chiva needle. Blood flow in side the malformation was slow in all cases and no afference to the no rmal venous system was detected. We embolized with 5-15 cc (mean 7.5 c c) of a mixture of ethibloc and ethanol. Results: The mean follow-up p eriod was 17 months (range 14-21). All patients remain asymptomatic an d have resumed normal daily life activities. There were no complicatio ns. Conclusion: Percutaneous embolization by direct puncture of intram uscular vascular malformations is a feasible and simple procedure. Our preliminary results are promising, although more extensive studies ne ed to be to performed in order to reach definite conclusions. (C) 1998 Elsevier Science ireland Ltd. All rights reserved.