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J Vasc Surg Venous Lymphat Disord. 2017 May;5(3):417-420. doi: 10.1016/j.jvsv.2016.12.001. Epub 2017 Feb 8.

Chronic refractory venous ulcer exacerbated by a congenital pelvic arteriovenous malformation successfully treated by transarterial Onyx embolization.

Author information

1
Vascular Anomalies & Malformations Program (VAMP) at the Division of Vascular Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, Bristol-Myers Squibb Children's Hospital, New Brunswick, NJ. Electronic address: nn207@rutgers.edu.
2
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
3
Director for the Center for Wound Healing at Robert Wood Johnson University Hospital, New Brunswick, NJ.
4
Division of Vascular Surgery, Department of Surgery, The Center for Wound Healing, Rutgers Robert Wood Johnson Medical School, Robert Wood Johnson University Hospital, New Brunswick, NJ.

Abstract

Congenital arteriovenous malformations (AVMs) are an important but often neglected cause of lower extremity venous hypertension. A case of a chronic refractory venous stasis ulcer of the lower extremity exacerbated by a pelvic AVM is presented. Healing of the ulcer was achieved at 2 months without recurrence at 1 year after superselective ethylene vinyl alcohol copolymer (Onyx 34; ev3, Covidien, Plymouth, Minn) embolization of the AVM nidus. Chronic venous arterialization should be considered in cases of refractory, nonhealing venous ulcers. Embolotherapy in addition to standard of care therapy can be a therapeutic measure. Modification of the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification to include AVMs as a contributing pathophysiologic process is suggested.

Comment in

PMID:
28411709
DOI:
10.1016/j.jvsv.2016.12.001
[Indexed for MEDLINE]

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