Resección quirúrgica de malformación arteriovenosa de alto flujo en ángulo nasogeniano con embolización preoperatoria: reporte de un caso / Surgical resection of high-flow arteriovenous malformation of the nasogenian sulcus with preoperatory embolization: a case report

El 50% de las malformaciones arteriovenosas (MAVs) de alto flujo se ubican en la región craneofacial y pueden producir sangrado con riesgo vital sin diagnóstico y tratamiento adecuado. La resonancia magnética (RM) es útil en el diagnóstico diferencial de las lesiones vasculares, siendo el gold standard la angiografía selectiva. Dado que las MAVs de alto flujo no involucionan espontáneamente, el tratamiento usualmente consiste en embolización con posterior resección quirúrgica. Se presenta un paciente de sexo masculino de 20 años que consulta por aumento de volumen nasogeniano derecho, progresivo, violáceo, blando y pulsátil. Se objetiva mediante RM una zona de vasos serpentiginosos, que se extiende desde el subcutáneo hasta la pared anterior del maxilar. La angiografía cerebral confirma MAV de alto flujo e informa mapeo vascular. Se decide embolización prequirúrgica superselectiva con posterior resección tumoral mediante acceso transvestibular.

The 50 % of arteriovenous malformations (AVMs) of high flow are located in the craniofacial region and can cause life-threatening bleeding without a diagnosis and appropriate treatment. Magnetic resonance imaging is useful in the differential diagnosis of vascular lesions, being the gold standard selective angiography. Since high-flowA VMs do not regress spontaneously, treatment usually involves surgical resection with subsequent embolization. We present a 20 years male patient consulting with a purple, progressive, soft, pulsating enlargement of right-side nasogenian region. Magnetic resonance imaging shows serpiginous vessels, extending from the subcutaneous to the anterior wall of the maxillary. Cerebral angiography confirms high flowAVM and shows vascular mapping. It was decided superselective preoperative embolization with subsequent tumor by transvestibular access.

A Case of High-flow Priapism Treated by Superselective Embolizations of Bilateral Cavernosal Arteries / 대한비뇨기과학회지

We report a case of priapism secondary to bilateral rupture of the cavernosal arteries following perineal blunt trauma in a 34 year old man. He complained of painless but persistent erection for the period of 1 week. We confirmed non-ischemic high-flow priapism by arterial blood gas analysis, Doppler ultrasonography and arteriography. Arteriography showed a leakage on both sides of the end of the cavernosal arteries and the leakage was blocked by superselective cavernosal artery embolization. After the embolization, tumescence began to disappear and the detumescence process was completed on the third day. The examination of the patient after 4 months following embolization revealed that the patient was fully free of priapism and returned to the normal erectile status like before his priapism. During 2 years of follow up, the patient had no complications such as priapism or impotence.