Interventional therapy of extracranial arteriovenous malformations of the head and neck—A systematic review

• Published in: PloS one Vol. 17; no. 7; p. e0268809
• Main Authors: Lilje, Daniel, Wiesmann, Martin, Hasan, Dimah, Riabikin, Alexander, Ridwan, Hani, Hölzle, Frank, Nikoubashman, Omid
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 15-07-2022; Public Library of Science (PLoS)
• Subjects: Arteriovenous malformations; Bias; Biology and Life Sciences; Care and treatment; Carotid arteries; Curing; Diagnosis; Embolization; Ethanol; Evaluation; Evidence-based medicine; Head and neck; Intervention; Literature reviews; Magnetic resonance imaging; Medical imaging; Medicine and Health Sciences; Meta-analysis; Patients; Physical Sciences; Quality of life; Research and Analysis Methods; Sclerotherapy; Search engines; Search strategies; Soft tissues; Statistical analysis; Systematic review; Veins & arteries; Germany
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0268809

The primary aim of this study was to conduct a meta-analysis of the literature on interventional treatment for patients with extracranial AVM of the head and neck to identify a superior treatment. The secondary aim was to evaluate the methodological quality of associated articles published between 2000-2020. The literature search was conducted on PubMed, Embase, the Cochrane Library, and scholar.google.com. Studies, meeting the acceptable reference standard underwent meta-analysis. All identified literature underwent methodological quality analysis. Of 1560 screened articles, 56 were included in the literature review. Appropriate diagnostic tests were reported in 98% of included articles. 13% of included articles did not specify the embolization agent. Outcome analysis varied throughout. 45% of the authors used radiographic imaging for follow-up. 77% specified the span of follow-up of their entire patient collective. Two articles met the inclusion criteria for meta-analysis. Curing rate of transarterial ethanol embolization for intraosseous AVM was 83% with a complication rate of 58%. Curing rate of ethanol combined with NBCA or Onyx in soft tissue AVM was 18% with a complication rate of 87%. Our literature review revealed an absence of treatment or reporting standards for extracranial AVM of the head and neck. The meta-analysis is comprised of two articles and methodological quality is heterogeneous. We recommend implementing consistent reporting standards to facilitate comparability of studies and to provide robust data for the development of an evidence-based treatment strategy.