[Current classification of vascular malformations].
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Biomedical subjects
Publications and source records attributed to E Hadjean.
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It is well known that proximal arterial ligations have no curative effect on arterio-venous malformations, unfortunately however they are still employed. The immediate and late consequences of such ligatures have been studied by analysing 36 out of 142 cases of arterio-venous malformations. These ligatures interfere with ulterior treatment. At present such a treatment relies on a combination of radio-surgical treatment associated with embolization and complete surgical excision of the malformation, whenever it is possible.
In the light of 230 cases of vascular malformations in the cervico-facial region and the scalp treated over a 7 year period, the value of embolization is specified. Embolization permits effective treatment of the complications of these lesions, in particular haemorrhage. The reduction of swelling that can be obtained is always marked, but often incomplete : this is largely due to an associated hypertrophy of the neighbouring nonangiomatous tissues : such hypertrophy most often necessitates plastic surgery in order to obtain complete correction of the local disfigurement. With the introduction of embolization, the scope for surgery has been radically transformed, and one can often now consider a complete eradication of an extensive vascular malformation as well as correction of the associated local tissue dystrophy.
After describing the different collateral sytems between the various cervicocephalic arteries, the authors indicate the consequences of ligation of the external carotid. This ligation proves to totally ineffective for distal vascular lesions and severely compromises the possibilities of later treatment.
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