Outcome and Prognostic Factors of Surgical Management of Scalp AVMs.

Last updated: January 31, 2023
Sponsor: Assiut University
Overall Status: Active - Recruiting

Phase

N/A

Condition

Aneurysm

Treatment

N/A

Clinical Study ID

NCT05341336
OPFSMSAM
  • All Genders

Study Summary

Scalp arteriovenous malformations (AVMs) are rarely encountered vascular scalp anomalies that represent 8% of all AVMs. Different terms are being used to describe the vascular anomalies of the scalp include cirsoid aneurysm, racemosum aneurysm, plexiform angioma, arteriovenous fistula and arteriovenous malformation. Derived from the Greek language, kirsos, the term cirsoid aneurysm is used to describe the AVM as it resembles varix. Case studies reported approximately 200 cases with increased prevalence during the last 15 years. The etiology of scalp AVMs remains controversial, it can be spontaneous or traumatic. They generally develop in the trauma background and in patients over 30-year-old while spontaneous scalp AVM may present at birth and remains asymptomatic until adulthood.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Patients with scalp AVMs confirmed by various imaging techniques. AVMs of the scalpwill include: cirsoid aneurysm, serpentinum aneurysm, racemosum aneurysm, plexiformangioma, arteriovenous fistula, high flow shunts and arteriovenous malformations.
  • Age group: any age group.
  • Aetiology: congenital, traumatic, or any.

Exclusion

Exclusion Criteria:

  • High risk patients or unfit for surgery.
  • Patients refused surgery, or scheduled for endovascular intervention.

Study Design

Total Participants: 15
Study Start date:
July 01, 2022
Estimated Completion Date:
December 31, 2023

Study Description

Patients with scalp AVMs are usually presented with scalp swelling, and cosmetic concerns along with other presentations including headache, pain, tinnitus, audible bruits, palpable thrills, and hemorrhage. Neuro-radiological diagnosis is the cornerstone for the surgical procedure to be performed, and cranial angiography is of great significance for diagnosis and treatment selection. MRA is also of significance for establishing a diagnosis as scalp AVMs are confused with hemangioma and cavernomas. Treatment of the cirsoid aneurysm is difficult due to the abnormal fistulous communications between the feeding arteries and veins and high shunt flow. Management protocols for scalp AVMs include various options including surgical excision, endovascular embolization, ligation, and intralesional injections. Operative blood loss, postoperative cosmetic complications are significant concerns when treating scalp AVMs, thus various methods are used pre and postoperatively in order to control these concerns. A thorough analysis of scalp AVMs regarding anatomy, feeder vessels, size, and other different variables is required for a better understanding of the problem in order to improve the outcomes.

Connect with a study center

  • Assiut University Hospitals

    Assiut, 71515
    Egypt

    Active - Recruiting

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