Management of low-flow vascular malformations of upper aero digestive system—role of N-butyl cyanoacrylate in peroperative devascularization

ObjectivesLow-flow vascular malformations of upper aero digestive system may cause difficulty in swallowing and/or breathing and bleeding from these lesions may even threaten the life of patient due to risk of aspiration. These lesions may require surgical resection with prior devascularization to minimize blood loss during surgery.MethodsPeroperative devascularization of vascular malformations was carried in patients of our study group by injecting N-butyl cyanoacrylate (NBCA) into vascular malformations using direct puncture technique. This was followed by surgical resection of lesion in the same sitting.ResultsSuccessful devascularization of vascular malformations in all patients in our study group was achieved by injection of NBCA into the lesion by direct puncture technique. There was retraction of malformation due to devascularization, good plane of cleavage was found during subsequent surgical resection and blood loss was minimal.ConclusionsLow-flow vascular malformations of upper aero digestive system can be treated with surgical resection after peroperative devascularization. Direct puncture of NBCA into lesion under fluoroscopy control is an effective, safe and inexpensive method of devascularization which can be carried out by the surgeon in a single sitting.