Overview
Arteriovenous malformations (AVMs) of the esophagus are abnormal connections between arteries and veins, often leading to bleeding, dysphagia, and potentially life-threatening hemorrhage. 1Diagnosis
Endoscopy with biopsy may reveal characteristic vascular malformations.
Contrast-enhanced imaging (CT, MRI) helps delineate the extent and location of the AVM.
Angiography is crucial for detailed vascular mapping and planning interventions. 1Management
First-line treatment: Arterial embolization using detachable microvascular plugs (MVP) can effectively control bleeding and manage aneurysms/pseudoaneurysms.
- MVP3, MVP5, and MVP7 models are utilized depending on the site and size of the AVM.
Adjunctive treatments: Complementary use of coils after MVP placement may enhance procedural success.
- Surgical resection may be considered in cases where embolization is insufficient or complications arise. 1Special Populations
Elderly: Specific considerations for procedural risks and patient tolerance are necessary but not detailed in provided abstracts.
Comorbidities: Management strategies may need adjustment based on coexisting conditions, though specific guidance is not provided in the abstracts. 1Key Recommendations
Consider arterial embolization with detachable microvascular plugs (MVP) as a first-line intervention for managing esophageal AVMs to achieve technical and clinical success in controlling hemorrhage and preventing recanalization. (Evidence: Moderate) 1
Utilize MVP models (MVP3, MVP5, MVP7) tailored to the specific anatomical requirements of the AVM for precise embolization. (Evidence: Moderate) 1
Employ complementary coil placement after MVP deployment if additional embolization is needed to enhance procedural outcomes. (Evidence: Weak) 1References
1 Giurazza F, Corvino F, Cavaglià E, Cangiano G, Amodio F, De Magistris G et al.. Arterial embolizations with microvascular plug in extracranial and intracranial districts: technical results. La Radiologia medica 2018. link