ĐÁNH GIÁ KẾT QUẢ TRUNG HẠN ĐIỀU TRỊ DỊ DẠNG ĐỘNG – TĨNH MẠCH NGOẠI BIÊN BẰNG KỸ THUẬT THUYÊN TẮC DÙNG CỒN TUYỆT ĐỐI TẠI BỆNH VIỆN CHỢ RẪY

Abstract

Background: Peripheral arteriovenous malformations (AVMs) are rare and complex vascular conditions that require optimal and long-term treatment strategies. Absolute alcohol embolization via endovascular intervention has proven effective for treating AVMs. However, mid-term outcome studies of this method in Vietnam remain limited. Objective: To evaluate the mid-term outcomes of patients with AVMs treated using absolute alcohol embolization via endovascular intervention at Cho Ray Hospital. Subjects and Methods: A retrospective case series study was conducted from May 2019 to May 2022 at the Vascular Surgery Department, Cho Ray Hospital. Results: During the study period, 34 patients underwent a total of 54 embolization sessions. The mean age of the patients was 31.5 ± 12.2 years, comprising 15 males and 19 females. Most patients received a single embolization session (58.8%), while 23.5% and 17.6% underwent two or three sessions, respectively. All patients were treated via an intra-arterial approach, with 55.9% undergoing solely endovascular procedures and 44.1% undergoing a combination of endovascular and direct puncture techniques. Mid-term follow-up (16.2 ± 0.3 months) was achieved for 32 patients, with two lost to follow-up. The mid-term outcomes revealed that 50% of patients achieved complete recovery, 31.3% showed significant symptom improvement, 12.5% experienced no change, and 6.2% showed worsening symptoms. Schobinger stage evaluation indicated marked improvement post-treatment: 50% of patients were symptom-free, and other stages (I, II, III) significantly decreased compared to preoperative conditions (p = 0.006). Factors such as Schobinger stage and lesion size significantly impacted treatment outcomes (p < 0.05). No severe complications or fatalities were reported. Conclusion: Absolute alcohol embolization is an effective and safe method for treating AVMs, demonstrating favorable mid-term outcomes. This study highlights the potential for broader application of this technique in Vietnam