Work

Custom-made donut technique: An innovative approach to treating scalp arteriovenous fistula

Year: 2025

Type: article

Abstract: Scalp arteriovenous fistulas are rare, high-flow vascular anomalies, often of post-traumatic origin. Their management remains a subject of debate owing to the limited number of reported cases. This study presents a novel approach for the treatment of a post-traumatic right mastoid scalp arteriovenous fistula in a patient with a history of multiple unsuccessful treatments. A customized, in-house three-dimensional-printed device, designed in a donut shape, was used to enhance the precision of direct puncture embolization. This approach aimed to confine embolization exclusively to the fistula site, minimizing the risk of inadvertent occlusion of adjacent vessels and subsequent cutaneous necrosis. The treatment strategy combined endovascular embolization using precipitating hydrophobic injectable liquid with surgical resection in a single-stage procedure. The intervention was completed without intraoperative or postoperative complications. Follow-up assessments confirmed complete fistula occlusion with no recurrence and satisfactory functional and aesthetic outcomes. This innovative technique highlights the potential advantages of patient-specific three-dimensional-printed devices in optimizing embolization strategies for complex vascular malformations.

Source: Journal of Vascular Surgery Cases and Innovative Techniques

DOI: 10.1016/j.jvscit.2025.102092

Authors: Paolo Gennaro, Flavia Cascino, Simone Benedetti, Sandra Bracco, Samuele Cioni, Linda Latini

Institutions: University of Siena, Ospedale Santa Maria alle Scotte, Azienda Ospedaliera Universitaria Senese

Language: English

Topic: Vascular Malformations Diagnosis and Treatment

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250