Abstract
Arteriovenous malformations (AVMs) are high-flow vascular malformations characterised by a complex vessel network directly connecting feeding arteries and draining veins, typically featured by a natural history of progression, while spontaneous regressions are purely anecdotal.AVMs are very aggressive entities that possess a locally infiltrative behaviour like neoplasms. Complete "radical" surgical excision presents the highest chance of cure, but nowadays there is still considerable controversy on how to treat large AVMs that are not amenable of "radical" excision.The aim of this paper is to propose a different approach to treat vast AVMs that cannot be removed radically.The association of an antiangiogenic drug (to be initiated before surgery and to be continued in the post-operative period), could prevent the feared "explosive" growth of the remaining nidus after its partial removal. This could make recontouring and other "aesthetically" focused procedures feasible in these patients, with an obvious leap in their quality of life.The most promising antiangiogenic drug seems to be Thalidomide, but other drugs such as Sirolimus, VEGF pathway inhibitors, Interferon or Matrix Metalloproteinase (MMP) Inhibitors could serve the purpose just as well. Even Propranolol could prove useful in this sense as suggested by some recent researches on retinopathy of prematurity and tumour biology.
| Original language | English |
|---|---|
| Pages (from-to) | 298-302 |
| Number of pages | 5 |
| Journal | Medical Hypotheses |
| Volume | 85 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - Sep 1 2015 |
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ASJC Scopus subject areas
- Medicine(all)
Cite this
Adjuvant role of anti-angiogenic drugs in the management of head and neck arteriovenous malformations. / Colletti, Giacomo; Dalmonte, Pietro; Moneghini, Laura; Ferrari, Daris; Allevi, Fabiana.
In: Medical Hypotheses, Vol. 85, No. 3, 01.09.2015, p. 298-302.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Adjuvant role of anti-angiogenic drugs in the management of head and neck arteriovenous malformations
AU - Colletti, Giacomo
AU - Dalmonte, Pietro
AU - Moneghini, Laura
AU - Ferrari, Daris
AU - Allevi, Fabiana
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Arteriovenous malformations (AVMs) are high-flow vascular malformations characterised by a complex vessel network directly connecting feeding arteries and draining veins, typically featured by a natural history of progression, while spontaneous regressions are purely anecdotal.AVMs are very aggressive entities that possess a locally infiltrative behaviour like neoplasms. Complete "radical" surgical excision presents the highest chance of cure, but nowadays there is still considerable controversy on how to treat large AVMs that are not amenable of "radical" excision.The aim of this paper is to propose a different approach to treat vast AVMs that cannot be removed radically.The association of an antiangiogenic drug (to be initiated before surgery and to be continued in the post-operative period), could prevent the feared "explosive" growth of the remaining nidus after its partial removal. This could make recontouring and other "aesthetically" focused procedures feasible in these patients, with an obvious leap in their quality of life.The most promising antiangiogenic drug seems to be Thalidomide, but other drugs such as Sirolimus, VEGF pathway inhibitors, Interferon or Matrix Metalloproteinase (MMP) Inhibitors could serve the purpose just as well. Even Propranolol could prove useful in this sense as suggested by some recent researches on retinopathy of prematurity and tumour biology.
AB - Arteriovenous malformations (AVMs) are high-flow vascular malformations characterised by a complex vessel network directly connecting feeding arteries and draining veins, typically featured by a natural history of progression, while spontaneous regressions are purely anecdotal.AVMs are very aggressive entities that possess a locally infiltrative behaviour like neoplasms. Complete "radical" surgical excision presents the highest chance of cure, but nowadays there is still considerable controversy on how to treat large AVMs that are not amenable of "radical" excision.The aim of this paper is to propose a different approach to treat vast AVMs that cannot be removed radically.The association of an antiangiogenic drug (to be initiated before surgery and to be continued in the post-operative period), could prevent the feared "explosive" growth of the remaining nidus after its partial removal. This could make recontouring and other "aesthetically" focused procedures feasible in these patients, with an obvious leap in their quality of life.The most promising antiangiogenic drug seems to be Thalidomide, but other drugs such as Sirolimus, VEGF pathway inhibitors, Interferon or Matrix Metalloproteinase (MMP) Inhibitors could serve the purpose just as well. Even Propranolol could prove useful in this sense as suggested by some recent researches on retinopathy of prematurity and tumour biology.
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UR - http://www.scopus.com/inward/citedby.url?scp=84939568026&partnerID=8YFLogxK
U2 - 10.1016/j.mehy.2015.05.016
DO - 10.1016/j.mehy.2015.05.016
M3 - Article
C2 - 26049824
AN - SCOPUS:84939568026
VL - 85
SP - 298
EP - 302
JO - Medical Hypotheses
JF - Medical Hypotheses
SN - 0306-9877
IS - 3
ER -