PURPOSE:To assess the efficacy and safety of 'fractional' long-pulsed Nd:YAG (FLP-Nd:YAG) for the treatment of severe diffused glans penis venous malformations (GPVM). METHODS:Thirteen patients (Age 1.2-29 years) with diffused GPVM were enrolled in this study from August 2013 to January 2025. Twelve patients except one young male with erectile dysfunction underwent FLP-Nd:YAG laser treatment (there were intervals between circular spots). Outcome was graded using a five-point scale, and complications were documented after each session. RESULTS:Ten patients reached a 'nearly cured' status, and two patients achieved an 'excellent' outcome. The mean number of sessions was 3.2 (range 2 ∼ 5). Symptoms were significantly alleviated following treatment. The minor complications were blister formation or thin crusting (n = 4), temporary hyperpigmentation (n = 5), superficial scars (n = 2), and mild hypesthesia (n = 1). Major complications included localized tissue depression (n = 1) and long-term fibrous nodules (n = 1). All patients were followed up for 4 to 11 months. Mild recurrence was observed in three cases. CONCLUSION:FLP-Nd:YAG laser therapy achieved high lesion clearance rates with low incidence of major complications in severe diffused GPVMs. It offered rapid treatment with a noninvasive, bloodless procedure, making it especially suitable for pediatric patients.

Introduction:Synovial sarcoma (SS) is one of the most prevalent malignant soft tissue sarcomas in children and adolescents. Pediatric populations often present with atypical features, complicating the differentiation from benign intramuscular venous malformations (VMs). ​​Case presentation:An 11-year-old male with a four-year history of progressive right plantar pain and a compressible intramuscular mass. The initial magnetic resonance imaging (MRI) findings suggest VM, due to high signal in T2-weighted images. Sclerotherapy under digital subtraction angiography (DSA) revealed unexpected hyper-vascularity, prompting surgical exploration. Histopathology demonstrated spindle and epithelioid cells with hemangiopericytoma-like morphology and mitotic activity, while SS18-SSX1 gene rearrangement confirmed SS. Chemotherapy was then administered, without recurrence over two years. ​​Conclusion:SS may clinically and radiographically mimic benign vascular anomalies, particularly in children. Discrepancies in vascular dynamics on DSA and atypical imaging features warrant suspicion for malignancy. Early histopathological validation is critical to prevent diagnostic delays, optimize multimodal therapy, and improve outcomes in this aggressive tumor.

Objectives: Venous malformations (VMs) that infiltrate the muscular layer, involve or are closely adjacent to critical nerves or vessels, or are located deep within or very close to major organs in the thoracic or abdominal cavities are challenging to access during sclerotherapy, which we defined as inaccessible VMs. This study proposed an integrated real-time stereotactic MRI-guided sclerotherapy with bleomycin-polidocanol foam (RSMS-BPF) for the treatment of inaccessible VMs, focusing on its clinical feasibility, efficacy, and safety. Methods: A retrospective study was conducted involving patients treated with RSMS-BPF between 2019 and 2021. During the sclerotherapy, the intraoperative magnetic resonance imaging (MRI) was combined with an optical navigation system to guide precise needle placement and track BPF, a foam sclerosant optimized for MRI visibility. Radiological response was assessed by lesion volume, while clinical improvement was evaluated through patients’ description of their symptoms. Rigorous follow-up and documentation of complications were conducted. Results: A total of 42 patients (mean age 23.6 ± 1.6 years; 18 males) were treated in 64 sclerotherapy sessions. The treatment achieved an overall response rate of 89.5%. Imaging analysis revealed an average lesion volume reduction of 59.6%. 57.9% of patients achieved good or excellent radiological responses. After a median follow-up of 12.25 months, 60.53% of patients reported complete or significant relief. Lesion depth did not affect treatment efficacy (p = 0.43). Minor complications included skin hyperpigmentation (5.3%, 2/38) and blisters (2.6%, 1/38), with no major complications observed. Conclusions: RSMS-BPF demonstrated satisfactory efficacy and safety in VMs treatment, particularly for inaccessible VM lesions. It enables authentic real-time dynamic tracking during sclerotherapy, achieving unparalleled precision targeting while minimizing procedural risks. These findings strongly support routine integration of RSMS-BPF as first-line therapy for complex vascular malformations with critical anatomical constraints.

Purpose:Patients with congestive heart failure (CHF) are associated with an elevated risk of mortality and poor prognosis. Contrast-induced acute kidney injury (CI-AKI), a common complication in CHF patients undergoing contrast-enhanced procedures, exacerbates renal dysfunction and contributes to adverse outcomes. However, the relationship between the preoperative fibrinogen/albumin ratio (FAR) and the risk of CI-AKI or all-cause mortality in CHF remains unclear. This study analyzed the correlation of FAR with the risk of CI-AKI and all-cause mortality in patients with CHF. Patients and Methods:In this retrospective observational study, CHF patients undergoing coronary angiography (CAG) were enrolled and grouped according to their FAR quartiles. The association between FAR and clinical outcomes was assessed using the multivariate logistic regression and restricted cubic spline (RCS) analyses. Results:This study included 7,235 CHF patients with a mean age of 65.8 ± 11.7 years. Among these, 2,100 were female (29.0%), and 1,094 (15.1%) experienced CI-AKI. FAR showed a non-linear relationship with CI-AKI (p < 0.001). The risk of CI-AKI was significantly higher with increasing FAR. After adjusting for all the potential confounding variables, the risk of CI-AKI was highest in patients with FAR >0.150 (OR = 1.572, 95% CI 1.237-2.004, p < 0.001). Multivariate COX proportional risk model showed that the risk of all-cause mortality was highest in CHF patients with FAR > 0.150 (HR = 1.20, 95% CI 1.04-1.38, p = 0.014). Conclusion:FAR is an independent risk factor for the occurrence of CI-AKI in patients with CHF.

Background: Vascular malformations (VAMs) impose multifaceted burdens extending beyond physical impairments to psychosocial dysfunction. While prior studies predominantly utilized generic quality-of-life instruments, disease-specific tools are critical for addressing heterogeneous symptom profiles and sociocultural variability, particularly in understudied Asian populations. This study investigated psychosocial impacts across pediatric and adult VAM patients via validated, condition-specific measures. Methods: A prospective cohort of 233 hospitalized VAM patients (114 pediatric patients, 119 adult patients) completed the OVAMA questionnaire, and 114 adult, 68 pediatric patients, and 115 parent-proxies completed corresponding PROMIS questionnaires. The subtypes included arteriovenous malformations (AVMs), venous/lymphatic/lymphovenous malformations (VMs/LMs/LVMs), port-wine stains (PWSs), and other vascular malformations. Statistical analyses (Mann-Whitney U test, Kruskal-Wallis test, linear regression) were used to evaluate associations between demographics, clinical characteristics, and psychosocial outcomes. Results: Compared with children, adults reported significantly greater distress related to general (p = 0.004) and appearance (p = 0.003) problems. Compared with AVM (p = 0.01) and PWS (p = 0.041) patients, VM/LM/LVM patients presented elevated general problem scores. Pain and bleeding were related to general problems, whereas temporary enlargement was related togeneral and appearance problems. The PROMIS results revealed that 42.1% of adults had below-normal psychosocial-positive scores, whereas 33% demonstrated abnormal psychosocial-negative scores. Pediatric self-reports were associated with higher anxiety and depression rates than parent proxies were, with the VM/LM/LVM subgroups reporting poorer family relationships (p = 0.0062) and life purposes (p = 0.0075). Treatment frequency was correlated with increased psychological stress in children (p = 0.007). Conclusion: VAMs significantly impair psychosocial functioning across all ages, with adults experiencing heightened distress and social role deficits. Pediatric patients with low-flow malformations (VMs/LMs/LVMs) face compound depressive symptoms and familial strain. Disease-specific tools such as OVAMA and PROMIS are essential for comprehensive assessments, guiding tailored interventions to address both physical and psychosocial burdens.

Objectives: This study assesses the efficacy of tracheotomy-primed sclerotherapy in craniofacial venous malformations (VMs), establishes evidence-based airway intervention criteria, and develops site-specific safety protocols to optimize treatment timing and safety in cases with upper airway compromise. Methods: We retrospectively collected the clinical data of 35 patients treated by our center between January 2008 and November 2024, who were diagnosed with cervicofacial VMs involving the upper respiratory tract. All patients underwent direct tracheotomy or tracheotomy after sclerotherapy for lesions located in the anterior cervical area. Sclerotherapy was performed under fluoroscopy or laryngoscopy after tracheotomy. Results: 35 patients underwent 225 sclerotherapy sessions. Nineteen patients underwent tracheotomy directly, and sixteen patients received sclerotherapy at the anterior cervical area before tracheotomy. All patients presented improvement according to magnetic resonance imaging (MRI) findings, and 94.29% (33/35) of patients reported improvement in clinical presentations. All patients experienced improvement in quality of life (QoL). No major complications occurred. Decannulation was successfully performed in all 35 patients after finishing sclerotherapy. Conclusions: Tracheotomy followed by sclerotherapy is safe and effective for VMs involving the upper respiratory tract. This is necessary for patients with lesions involving the laryngopharyngeal region, tongue base, and bilateral pharyngeal walls. In high-risk prophylactic tracheostomy candidates, anterior cervical sclerotherapy-tracheostomy-sclerotherapy (ACSTS) is an effective strategy for managing airway obstruction.

BACKGROUND:Scalp arteriovenous malformation (AVM) and its clinical course associated with ulcerative hemorrhage and local alopecia are rarely reported. CASE REPORT:An 18-year-old male presented to a vascular anomalies center with scalp AVM and ulcerative hemorrhages over a 6-month period due to post-excision recurrence, initially associated with thinning hair and scalp erythema around the AVM lesion. After meticulous debridement, the patient was immediately given an ethanol embolization. He was advised against home wound care to prevent possible hemorrhage. After several effective interventional sessions over an 18-month period, not only was the AVM lesion extensively eliminated, but restoration of hair growth around the lesion was observed. This phenomenon may be attributed to the alleviation of deep, high-flow AVM steal phenomenon, which in turn restored normal blood supply to superficial layers, promoting ulcer healing and hair regrowth. CONCLUSION:This report suggests that scalp AVMs can be accompanied by AVM-related alopecia, which may recover after ethanol embolization. This report also suggests that restrictive debridement during multiple intervention sessions can be feasible in ulcerated AVMs with a high risk of hemorrhage.

OBJECTIVE:The purpose of this study was to compare the efficacy and safety between two sclerosants for venous malformations (VMs), bleomycin polidocanol foam (BPF) and absolute ethanol (AE), and provide more clinical evidence for the application of BPF for VMs. METHODS:We conducted a retrospective study of 104 patients with VMs who had been treated with BPF and AE sclerotherapy. Patients were followed-up after treatment to assess clinical efficacy and complications. Clinical efficacy was independently evaluated by three experts based on pre- and post-treatment photos and magnetic resonance images. Complications were categorized according to the Society of Interventional Radiology Adverse Event Classification System. RESULTS:A total of 104 patients with VM were enrolled in this study, of which 53 (51%) received BPF sclerotherapy, and 51 (49%) received AE sclerotherapy. Most of the patients had head and neck VMs (n = 64; 62%), and the most common symptom was disfigurement. The number of sessions in the BPF group was significantly lower than in the AE group (1.5 vs 2.2; P < .05). The median treatment efficacy score was 3.0 for the BPF group and 2.7 for the AE group, with no significant difference between two groups. The median follow-up was 45 months for the BPF group and 33 months for the AE group, with no significant difference between two groups. Complications occurred in 11 patients in the BPF group and in 15 patients in the AE group, but there was no significant difference between the two groups. Mild adverse events occurred in 10 of 53 patients (19%) in the BPF group and 10 of 51 (20%) in the AE group. Moderate adverse events occurred in one patient (2%) in the BPF group and three patients (6%) in the AE group. Two patients (4%) in the AE group had nerve injury, evaluated as severe adverse events, whereas no patients in the BPF group did. CONCLUSIONS:BPF has comparable treatment efficacy to AE in sclerotherapy for VMs. BPF showed a trend toward a lower rate of severe adverse events, although this difference was not statistically significant in our cohort. It could be an optimal sclerosant to treat VMs.

Vascular malformations are congenital vascular developmental defects that usually grow slowly and persist throughout life. Venous malformations (VMs) are the most prevalent type of vascular anomalies, representing roughly 70% of all cases. VMs can cause significant pain, impaired mobility, disrupt organ function, and in severe cases, become life-threatening. Intralesional sclerotherapy after tracheotomy is a safe and effective treatment for extensive VMs involving oropharyngeal areas of the head and neck. For the first time, we present a life-threatening case in which tracheostomy was not feasible and describe the implemented multidiscipline treatment approaches.

The vascular system plays a crucial role in maintaining homeostasis, ensuring the supply of oxygen and nutrients to tissues, while facilitating the removal of metabolic waste. Additionally, it contributes to immune defense, temperature regulation, and the transport of hormones and signaling molecules. Vascular anomaly (VA) arises due to developmental abnormalities or functional defects in the vessels. This review describes venous malformations (VM), a rare disorder predominantly caused by somatic mutations. Advances in recent research have substantially improved our understanding of the molecular mechanisms underlying these malformations, largely through the identification of their genetic origins and the study of animal models and endothelial cells derived from patients. Most of the somatic mutations associated with venous malformations affect genes within oncogenic growth factor signaling pathways, making it possible to repurpose certain cancer therapies to treat these VAs. This article summarizes the key molecular findings and explores emerging therapeutic strategies aimed at novel targets.

Wound infections, especially those caused by pathogenic bacteria, present a considerable public health concern due to associated complications and poor therapeutic outcomes. Herein, we developed antibacterial nanoparticles, namely, PGTP, by coordinating guanidine derivatives with a porphyrin-based sonosensitizer. The synthesized PGTP nanoparticles, characterized by their strong positive charge, effectively disrupted the bacterial biosynthesis process through charge interference, demonstrating efficacy against both Gram-negative and Gram-positive bacteria. Additionally, PGTP nanoparticles generated reactive oxygen species under ultrasound stimulation, resulting in the disruption of biofilm integrity and efficient elimination of pathogens. RNA-seq analysis unveiled the detailed mechanism of wound healing, revealing that PGTP nanoparticles, when coupled with ultrasound, impair bacterial metabolism by interfering with the synthesis and transcription of amino acids. This study presents a novel approach to combatting wound infections through ultrasound-driven charge-interfering therapy, facilitated by advanced antibacterial nanomaterials.

BACKGROUND:Capillary malformation-arteriovenous malformation (CM-AVM) is a rare genetic disorder characterized by multiple small capillary malformations (CMs) and arteriovenous malformations (AVMs), which has been linked with pathogenic variants in RASA1 and EPHB4. However, more data are needed to explore the phenotypic characteristics and the association between genotypes and clinical phenotypes. OBJECTIVES:Our aim was to investigate the phenotypic and genetic characteristics of CM-AVM in East Asians, identify potential unique phenotypes, and conduct genotype-phenotype association analyses. METHODS:This is a single-center study prospectively collecting CM-AVM patients' clinical data, with genetic data from blood or tissue samples. RESULTS:A total of 59 patients were enrolled. Thirty-two individuals had a leading CM greater than Schobinger stage II. The trigeminal nerve branches and greater auricular, transverse cervical, and lesser occipital nerves' somatosensory innervation zones divided head and neck CMs into six zones: V1, V2, V3, GA, TC, and LO zones. GA, TC, and LO zones had a positive correlation with one another but a negative correlation with V2 zone involvement. The RASA1 and EPHB4 pathogenic variants were detected in 41 out of 59, which showed two types of variant allele frequency (VAF) distributions. VAF above 30% made RASA1 pathogenic variants more susceptible to multifocal CMs than those below 30%. CONCLUSIONS:Leading CMs in the head and neck exhibit two segmentation patterns, anterior and lateral, which may differ in ear involvement and progression. Germline RASA1 pathogenic variants increased multifocal CM risk more than the somatic variants.

Arteriovenous malformations (AVMs) are aggressive congenital high-flow vascular anomalies, in which the feeding artery and draining vein are connected through fistulas without normal capillary networks. In severe cases, the condition may cause swelling, ulceration, bleeding, and even heart failure. Various treatment options are available for AVMs, including laser, surgical resection, embolization, and targeted drug therapy. With the development of endovascular treatment technology, absolute ethanol embolization of AVMs has become one of the first-line therapies owing to its sustained efficacy and low recurrence rate. However, administration of this therapy is challenging and may lead to serious complications if inappropriately managed. In this article, we reviewed and summarized previous clinical articles, literature reviews, and clinical trial data to comprehensively describe clinical manifestations of AVMs, the mechanism of ethanol embolotherapy, key points in treatment and management of complications, and issues that need to be addressed. We expect to provide a reliable information reference source for clinical physicians and researchers.

Arteriovenous malformations (AVMs) are serious congenital vascular anomalies in which the arteries connect directly with veins without capillaries. This condition will continue to worsen without proper intervention and cause ulcers, repeated hemorrhages, and even cardiac insufficiency. Primary treatment options for AVMs include surgery and interventional treatment; however, they are associated with high risk and recurrence rates. Recent studies revealed that excessive activation of the Ras/MAPK pathway can induce the formation and development of peripheral AVM, whereas MEK inhibitors can effectively control nidus progression, making them a potential novel treatment for AVM. This review provides an up-to-date overview of correlated laboratory and clinical research to provide information for further research and clinical practice.

We thank Shah et al for their meaningful comments, and we are glad to see this issue result in great interest, not just from investigators of vascular anomalies. However, after careful study, we believed they misunderstood some important information, and we are still confident in our results. Venous malformation (VM), a type of congenital vascular malformation with a long and relatively stable course, has a high risk of localized intravascular coagulation (LIC), which is characterized by elevated D-dimer and/or fibrin degradation product levels and a low fibrinogen level. A large surface area, muscle involvement, and palpable phleboliths are strong predictable criteria for LIC.1Dompmartin A. Acher A. Thibon P. et al.Association of localized intravascular coagulopathy with venous malformations.Arch Dermatol. 2008; 144: 873-877Crossref PubMed Scopus (234) Google Scholar A VM with LIC is generally tolerable for most patients and might not cause impaired renal function. This observational study was performed in accordance with the STROBE (strengthening the reporting of observational studies in epidemiology) statement and reported the eligibility criteria and methods of participant selection in the Methods section.2Cuschieri S. The STROBE guidelines.Saudi J Anaesth. 2019; 13: S31-S34Crossref PubMed Scopus (766) Google Scholar As we described in the contraindications for patient inclusion, no patient with a history of impaired renal function was enrolled. No consensus has been reached regarding the use anticoagulant therapy for patients with VMs, especially regarding dabigatran etexilate.3van der Vleuten C.J.M. Zwerink L. Klappe E.M. de Jong E. Te Loo D. Is there a place for prophylaxis with DOACs in Klippel-Trenaunay syndrome and other low-flow vascular malformations with intravascular coagulopathy and thromboembolic events?.Thromb Res. 2022; 213: 30-33Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar,4Budge E.J. Khalil Allam M.A. Mechie I. Scully M. Agu O. Lim C.S. Venous malformations: coagulopathy control and treatment methods.Phlebology. 2021; 36: 361-374Crossref PubMed Scopus (6) Google Scholar When to start and when to stop are two key questions. Our study addressed two conditions: (1) pain potentially caused by LIC; and (2) the improvement of coagulation status to allow for further treatment. Both short- and long-term use of dabigatran etexilate can relieve pain and improve coagulation status, in some cases, in as short as 2 days. Shah et al misunderstood the data presented in our Table II, which illustrated that the change (differences) in four indexes (index names provided in column 1) before and after treatment (columns 2 and 3, respectively) between the two duration groups showed no statistical significance (P values in column 4). The differences in the visual analog scale scores and fibrinogen levels from before to after treatment were statistically significant between the two duration groups. The difference in the D-dimer levels was also statistically significant in the short-term group. To check the confounders for the two duration groups, we used the Fisher exact test for gender and unpaired t tests for age, visual analog scale scores, and fibrinogen, D-dimer, and fibrin degradation product levels and did not find any statistical significance (P > .1 for all). We conducted our study, enrolling all outpatients, in the vascular anomaly center of the Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, which performs ∼30,000 outpatient services annually. For statistical analysis, we use GraphPad Prism 8 to conduct paired t tests for paired continuous variables between before and after treatment, and unpaired t tests for continuous variables between the two duration groups. According to our center's experience, LIC can cause hemorrhagic complications, local ulceration, and, eventually, can progress to disseminated intravascular coagulation in severe cases (Fig). A coagulation disorder can be a contraindication for emergency anesthesia and surgery. A quick correction of coagulation status, in particular, elevating the fibrinogen level, is necessary and urgent. Thus, the use of dabigatran etexilate can be an option. Our study accounted for a modest spur to induce more high-quality retrospective or prospective studies to standardize the use of anticoagulant therapy for patients with VMs. We hope that a consensus can be reached with guidelines provided for pain management and LIC treatment for those with VMs. Dabigatran for venous malformations: A call for a stringent approachJournal of Vascular Surgery: Venous and Lymphatic DisordersVol. 11Issue 5PreviewGiven the health burden of venous malformations, the study by Liu et al1 is a commendable effort to evaluate the efficacy and safety of dabigatran. The study concluded that dabigatran is a viable treatment option for managing pain and localized intravascular coagulation. However, we believe the authors have drawn significant correlations based on a tenuous foundation. Full-Text PDF

The Journal of DermatologyVolume 50, Issue 4 p. e119-e120 LETTER TO THE EDITOR Recurrence and restart of sirolimus in vascular anomalies after withdrawal Hongyuan Liu, Hongyuan Liu orcid.org/0000-0002-1324-0842 Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorXi Yang, Xi Yang Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorHechen Jia, Hechen Jia Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorLi Hu, Li Hu Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorZian Xu, Zian Xu Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorHui Chen, Corresponding Author Hui Chen [email protected] Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China Correspondence Xiaoxi Lin and Hui Chen, Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China. Email: [email protected] and [email protected]Search for more papers by this authorXiaoxi Lin, Corresponding Author Xiaoxi Lin [email protected] Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China Correspondence Xiaoxi Lin and Hui Chen, Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China. Email: [email protected] and [email protected]Search for more papers by this author Hongyuan Liu, Hongyuan Liu orcid.org/0000-0002-1324-0842 Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorXi Yang, Xi Yang Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorHechen Jia, Hechen Jia Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorLi Hu, Li Hu Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorZian Xu, Zian Xu Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, ChinaSearch for more papers by this authorHui Chen, Corresponding Author Hui Chen [email protected] Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China Correspondence Xiaoxi Lin and Hui Chen, Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China. Email: [email protected] and [email protected]Search for more papers by this authorXiaoxi Lin, Corresponding Author Xiaoxi Lin [email protected] Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China Correspondence Xiaoxi Lin and Hui Chen, Plastic and Reconstructive Department, Shanghai Ninth People's Hospital, Shanghai, China. Email: [email protected] and [email protected]Search for more papers by this author First published: 28 November 2022 https://doi.org/10.1111/1346-8138.16649 Hongyuan Liu, Xi Yang and Hechen Jia should be considered as co-first-authors. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume50, Issue4April 2023Pages e119-e120 RelatedInformation

BACKGROUND Cutaneous erythema is one of the most common signs of arteriovenous malformations (AVMs) in the head and neck region, influencing aesthetic appearance. Surgical resection of AVMs may lead to cicatrization of the skin or aggravation of the lesion. Laser treatment, although effective in improving superficial vascular lesions, cannot prevent deep AVMs from further development. OBJECTIVE The authors propose an absolute ethanol embolization therapy that can effectively and safely eradicate the nidus with a favorable aesthetic outcome. METHODS The authors conducted a retrospective observational study of 14 AVM patients with distinct cutaneous erythema in the head and neck region undergoing embolotherapy in a single primary care center. Symptoms before and after treatment, complications, and degree of devascularization were recorded and assessed. Changes in cutaneous redness were evaluated using a previously reported quantitative measurement. RESULTS Complete symptomatic relief was observed in 5 patients, and major improvement was observed in 9 patients. The mean Δa* value of the color change had a significant reduction of 6.50 ± 4.04, p < .001, indicating a remarkable remission of cutaneous erythema. CONCLUSION Ethanol embolization is an effective and safe treatment for head and neck AVMs with excellent aesthetic outcomes and might become a potential treatment method for other superficial vascular anomalies.