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  • Migration of vascular embolisation material from the intravascular space to surrounding interstitial tissues in arteriovenous malformations

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Case Reports: Learning from unexpected outcome (positive or negative)
Migration of vascular embolisation material from the intravascular space to surrounding interstitial tissues in arteriovenous malformations
  1. Rohini J Patel1,
  2. Bard C Cosman2,
  3. Erik L Owens3 and
  4. Mahmoud B Malas1
  1. 1Vascular Surgery, University of California San Diego Health System, La Jolla, CA, USA
  2. 2General Surgery, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
  3. 3Vascular Surgery, Veterans Affairs San Diego Healthcare System, La Jolla, CA, USA
  1. Correspondence to Dr Rohini J Patel; rjpatel{at}health.ucsd.edu

Abstract

We present the case of a young man active duty in the military who initially presented with pelvic pain and fullness during sexual activity. Extensive workup showed a large pelvic arteriovenous malformation (AVM). He underwent over 10 interventional radiology procedures to embolise his AVM and suffered multiple postoperative complications resulting in exploratory laparotomies, bowel resections and ultimately a colostomy. Six years after his embolisation procedures, he was found on imaging to have gluteal fluid collections with metallic particles, presumed to be migrated Onyx from his angioembolisations as a result of non-target embolisation. Current literature does not document other instances of Onyx material migrating from an intravascular source to interstitial tissue.

  • Vascular surgery
  • General surgery
  • Radiology
  • Interventional radiology

https://doi.org/10.1136/bcr-2022-249406

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    Footnotes

    • Contributors Patient was under direct care of BCC and ELO who oversaw patient care and decision making. RJP and MBM wrote report. Supervised by MBM.

    • Funding Rohini J. Patel is supported through a grant with the National Library of Medicine: T15 Postdoctoral Training Grant Fellowship Program in Biomedical Informatics.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.