Alcohol
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Haemoglobinuria, tongue disorders and airway constriction: 25 case reports In a single-centre retrospective study involving 52 patients with lingual arteriovenous malformations, who received alcohol embolisation between July 2007 and June 2018 in China, 25 patients [including 15 male patients and 10 female patients] aged 9–51 years were described, who developed haemoglobinuria, tongue necrosis, tongue infection, haemorrhage or airway constriction following embolisation with alcohol. The patients with lingual arteriovenous malformations, were scheduled to undergo alcohol [ethanol] embolisation. All the patients received unspecified general anaesthesia before starting the procedure. Alcohol was injected into the nidus of lingual arteriovenous malformations, which were accessed by direct puncture, trans-arterial catheterisation, transvenous catheterisation or a combination of all. The patients required between 1–20 embolisations of 2.5–65mL alcohol. Subsequently, the patients developed complications secondary to the alcohol embolisation, presenting as transient haemoglobinuria (19 patients), transient haemoglobinuria with tongue infection (2 patients), transient haemoglobinuria with tongue necrosis (1 patient), transient haemoglobinuria with haemorrhage of puncture point (1 patient), transient haemoglobinuria with airway constriction (1 patient) or tongue necrosis (1 patient). Some patients additionally received polyvinyl alcohol or bleomycin as preventive medications. The patients’ transient hemoglobinuria was treated with ringer’s-lactate and the haemoglobinuria resolved within 5–6 hours. Additionally, events of tongue infection were treated with antibiotics resulting in resolution, necrosis resolved following wound dressing, airway constriction was treated with tracheoplasty, whereas the event of haemorrhage was treated by applying continuous pressure. The treatment was continued in all the patients and was reported to be ongoing in 5 patients. One patient (51-year-old man) additionally exhibited lack of response to the alcohol embolisation. Zheng L, et al. Ethanol embolization of lingual arteriovenous malformations: Positive experience in 52 patients during 11 years. Journal of Vascular Surgery 72: 651-657.e4, 803499147 No. 2, Aug 2020. Available from: URL: http://doi.org/10.1016/j.jvs.2019.08.286
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Reactions 5 Sep 2020 No. 1820
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