부산대학교 도서관

Background: Parkes-Weber syndrome is a rare congenital vascular abnormality involving aggressive overgrowth of vascular structures. Destruction of the surrounding bone, muscle, and joint tissues often occurs, resulting in pain while walking and reduced range of motion. Current treatments for this arteriovenous malformation options include conservative therapy, minimally invasive endovascular treatments, and traditional open surgery. The choice of therapy is based on medical history and underlying health problems, although there is some debate regarding the safety and efficacy of treatment protocols for knee arteriovenous malformations involving advanced bone destruction, such as Parkes-Weber syndrome. Limb amputation significantly affects quality of life; however, limb-preservation surgery carries the risk of massive, potentially fatal, intraoperative blood loss. Objective: This study aimed to investigate the efficacy of a novel three-step alternative approach for treating advanced knee arteriovenous malformation with bone destruction. The stages were: (i) preoperative embolization, (ii) surgical excision of the lesion, and (iii) total knee arthroplasty to restore knee function. Case study and result: Using this three-staged intervention, we successfully removed a knee arteriovenous malformation with extensive bone destruction, and subsequently restored knee function and range of motion through total knee arthroplasty. Motion and mobility were improved. Conclusions: The combination of preoperative embolization and open surgery may reduce intraoperative blood loss and ensure safe and effective excision of advanced arteriovenous malformation. This study demonstrates the potential benefits of this novel approach for patients who are facing limb amputation.