Document Detail


Combined embolization and surgical treatment of arteriovenous malformation of the orbit.
MedLine Citation:
PMID:  8328538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We examined three patients with arteriovenous malformation of the orbit. At initial examination, all patients had a slowly progressive mass effect combined with congestive symptoms and clinical signs typical of an orbital vascular lesion. Arteriovenous malformation of the orbit was diagnosed on the basis of clinical and radiographic assessment, including the use of digital subtraction angiography and in one patient, magnetic resonance imaging. Treatment of each patient involved neuroradiologic embolization of the vascular lesion followed by surgical excision. Transient complications of endovascular management occurred. In one patient particulate emboli migrated into the central retinal artery after postembolization orbital surgical excision; consequent focal ischemic retinopathy contributed to short-term visual field deficits, which eventually resolved spontaneously. In another patient, spasm of the ophthalmic artery occurred during embolization, resulting in a transient afferent pupillary defect and loss in visual acuity to 20/60, which resolved over the subsequent week. High-flow orbital vascular lesions represent a considerable treatment challenge because of the complex anatomic and hemorrhagic characteristics of the malformation. Neuroradiologic characterization and embolization as a preoperative adjuvant is not without risk but offers an important advantage in the treatment of these formidable lesions. A combination of endovascular and surgical management may allow otherwise inoperable lesions to be treated successfully.
Authors:
R A Goldberg; G H Garcia; G R Duckwiler
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of ophthalmology     Volume:  116     ISSN:  0002-9394     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  1993 Jul 
Date Detail:
Created Date:  1993-08-12     Completed Date:  1993-08-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  17-25     Citation Subset:  AIM; IM    
Affiliation:
Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, Los Angeles, CA 90024-7006.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Angiography, Digital Subtraction
Arteriovenous Malformations / surgery,  therapy*
Combined Modality Therapy
Embolization, Therapeutic*
Female
Fundus Oculi
Humans
Magnetic Resonance Imaging
Male
Ophthalmic Artery / abnormalities,  surgery
Orbit / blood supply*
Postoperative Complications
Comments/Corrections
Comment In:
Am J Ophthalmol. 1993 Nov 15;116(5):655-6   [PMID:  8238237 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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