Percutaneous embolization using a combination of liquid embolic agents for the treatment of a large disfiguring venous malformation

Abstract

A 25-year-old man with a venous malformation (VM) along the anterior and posterolateral aspects of the right chest wall presented with progressive enlargement of VM, chest wall pain, and physical disfigurement. Because of the complexity and size of the VM, a staged multidisciplinary team approach, ie percutaneous embolization, followed by surgical resection and tissue-skin grafting was used. The percutaneous embolization was achieved with a combination of liquid embolic agents including n-butyl cyanoacrylate for the superficial cutaneous component and ethylene vinyl alcohol copolymer for the deeper subcutaneous component of the VM. Such a combination can achieve safe occlusion of the VM, facilitate surgical resection without blood loss, and contribute to a cosmetically desirable result.

Keywords

• Venous malformation
• Complex venous malformations
• Preoperative embolization
• Liquid embolic agent
• Ethylene vinyl alcohol copolymer
• EVOH