Abstract
Surgical outcomes of congenital soft tissue A-V fistulas and hemangiomas in 22 patients, comprising of 8 males and 14 females, are reported. Their ages ranged from 2 months to 46 years old with a mean of 18.9. These patients were followed up one to 17 years with a mean of 10.4. The chief complaints included swelling in all patients, bleeding in 3 and pain in 3. Sixteen patients had a solitary hemangioma and 6 had multiple hemangiomas. Fifteen hemangiomas were well defined and 7 were diffuse. The tumors were located at the head and neck in 11, the body in 8 and the extremities in 9. No patient had either congestive heart failure secondary to an A-V fistula or Kasabach-Merritt syndrome. Surgical procedures included extirpation in 17 patients, ligation of the feeder vessels followed by extirpation in 1, and ligation and embolization in 4. After extirpation, direct closure was achieved in 16 and free myocutaneous flap implantation was performed in 1 for reconstruction.
At the time of discharge no residual hemangioma was detected in 16 patients, and the size had decreased in 6. One patient with giant hemangioma of the face and neck died after the third operation. The remaining 21 patients are alive, and 12 have no recurrence. Nine patients are considered to have a good result. Extirpation for localized and well defined hemangiomas was curative. Ligation and embolization were effective for extensive or diffuse hemangiomas.
