Cutaneous necrosis following endovascular embolization by using ethylene-vinyl alcohol copolymer for arterio-venous malformations

Abstract

Arteriovenous malformations (AVMs) are intricate vascular anomalies marked by aberrant connections between dysplastic arteries and veins, often leading to a spectrum of complications. Treatment of AVMs consists of endovascular embolization, surgical resection or a combined approach. The endovascular embolization is an important and popular alternative treatment to reduce circulation of the nidus and prevent the development of collaterals and recurrence. However, local and systemic complications are quite common after repeated embolization, and surgical treatment is often required to manage such complications. This article presents a comprehensive analysis of a specific case, wherein a 32-year-old male patient with a gluteal AVM underwent ethylene vinyl alcohol copolymer (EVOH, Onyx®) embolization, subsequently developing large cutaneous necrosis. The core objective of this study was to search existing literature and provide insights into the management strategies employed in this unique scenario.