Arteriovenous malformations (AVMs) are abnormal communications between arteries and veins without an intervening capillary system. The best endovascular treatment option for these is unclear and may involve multiple staged procedures using a variety of embolic materials. We report our initial experience using a modified version of a previously published neurointerventional technique to treat soft tissue AVMs with single-stage curative intent. Soft tissue AVMs treated endovascularly using either sole arterial or combined arterial and venous balloon-assisted techniques with liquid embolic agents were retrospectively identified over a 3.5 year period (January 2017 to June 2020)) at two centres. Clinical, pre-operative radiological, procedural technical and post treatment details were recorded. Seven patients were treated for symptomatic soft tissue arteriovenous malformations. These AVMs were located in the peripheral limbs (five), tongue (one) and uterus (one). Curative treatment was achieved in 6/7 patients with one patient requiring a second treatment approximately 1 year later. A variety of liquid embolisation agents (LEAs) including sclerosants and polymers were used. Clinical success rate was 100% following treatment. One patient experienced expected temporary post-operative tongue swelling requiring tracheostomy occurred following embolisation of the lingual AVM. A minor complication in a second patient was due to an access site haematoma developed following treatment of the hand AVM requiring surgical intervention. No long-term sequelae or additional complications were observed. Endovascular arterial and venous balloon assisted LEA embolization of soft tissue AVMs with curative intent is feasible. This technique may provide an alternative treatment option for achieving durable occlusion for complex soft tissue AVMs.

中文翻译：

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软组织血管畸形的血管内球囊辅助液体栓塞：技术可行性和安全性

动静脉畸形 (AVM) 是动脉和静脉之间的异常交通，没有介入的毛细血管系统。对此的最佳血管内治疗方案尚不清楚，可能涉及使用各种栓塞材料的多阶段手术。我们报告了我们使用先前发布的神经介入技术的修改版本以单阶段治愈意图治疗软组织 AVM 的初步经验。两个中心在 3.5 年的时间里（2017 年 1 月至 2020 年 6 月）回顾性地确定了使用单独动脉或联合动脉和静脉球囊辅助技术和液体栓塞剂进行血管内治疗的软组织 AVM。记录临床、术前放射学、程序技术和治疗后细节。7 名患者因有症状的软组织动静脉畸形接受治疗。这些 AVM 位于外周肢体（五个）、舌头（一个）和子宫（一个）。6/7 患者获得了治愈性治疗，其中一名患者在大约 1 年后需要第二次治疗。使用了多种液体栓塞剂 (LEA)，包括硬化剂和聚合物。治疗后临床成功率为100%。一名患者在舌侧 AVM 栓塞后出现预期的临时性术后舌肿胀，需要气管切开术。第二名患者的轻微并发症是由于在需要手术干预的手部 AVM 治疗后出现的通路部位血肿。没有观察到长期后遗症或其他并发症。血管内动脉和静脉球囊辅助 LEA 栓塞软组织 AVM 是可行的。该技术可为复杂软组织 AVM 实现持久闭塞提供替代治疗选择。