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The Alternative to Radical Surgery

Patrick F. Joyce, MB, BCh, BAO, BSc, FRCR; Murali Sundaram, MB, BS, FRCR; M. Afzal Riaz, MB, BS, FRCR; Michael K. Wolverson, MB, BS, MRCP, FRCR; Hendrick B. Barner, MD; Robert J. Hoffman, MD

Arch Surg. 1980;115(5):665-668.

Abstract
• We describe two patients with extensive pelvic and lower limb angiodysplasias, in whom hemodynamic complications subsequently developed. These have been treated by selective angiography and multiple percutaneous transcatheter embolizations with satisfactory results (1 to four years of follow-up). One patient had had three previous operations with no improvement; amputation was the only surgical alternative. In the other patient, hip disarticulation and hemipelvectomy was seriously considered because of cardiac failure not responding to medical therapy. We review the literature and use our cases to illustrate points of technique and reemphasize the essential role of therapeutic embolization in the management of extensive angiodysplasia.

(Arch Surg 115:665-668, 1980)

Author Affiliations
From the Departments of Radiology (Drs Joyce, Sundaram, Riaz, and Wolverson), Surgery (Dr Barner), and Pediatrics (Dr Hoffman), St Louis University Hospitals.

Footnotes
Accepted for publication Dec 10, 1979.

Reprint requests to Department of Radiology, St Louis University Hospitals, 1325 S Grand Blvd, St Louis, MO 63104 (Dr Sundaram).

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ABSTRACT