Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia
Abstract Refractory ulcers caused by high-flow arteriovenous malformations (AVMs) pose significant therapeutic challenges due to persistent tissue ischemia and shear stress-induced graft failure. Traditional embolization or flap reconstruction strategies often yield suboptimal outcomes, particularly...
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| Language: | English |
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BMC
2025-06-01
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| Series: | Hereditas |
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| Online Access: | https://doi.org/10.1186/s41065-025-00479-4 |
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| author | Xiangyi Wu Ren Cai Mao Ye Xitao Yang Dachuan Sun Yifeng Han Xindong Fan Jiaxue Zhu |
| author_facet | Xiangyi Wu Ren Cai Mao Ye Xitao Yang Dachuan Sun Yifeng Han Xindong Fan Jiaxue Zhu |
| author_sort | Xiangyi Wu |
| collection | DOAJ |
| description | Abstract Refractory ulcers caused by high-flow arteriovenous malformations (AVMs) pose significant therapeutic challenges due to persistent tissue ischemia and shear stress-induced graft failure. Traditional embolization or flap reconstruction strategies often yield suboptimal outcomes, particularly in weight-bearing regions. We present a 28-year-old female with a non-healing dorsal foot AVM ulcer despite multiple embolizations and radical toe amputations. Genetic testing revealed a KRAS mutation, confirming a somatic etiology of AVM. After a debridement and local flap repair, we employed Ilizarov-assisted periosteal distraction to improve local perfusion. 75% of the wound epithelialized and the infection resolved within 4 weeks postoperatively, with granulation tissue covering the remainder. This case highlights the mechanobiological advantages of Ilizarov-based neovascular stimulation in AVM-related ischemic ulcers. |
| format | Article |
| id | doaj-art-52dc961d4e4e413fbb00c930616e8750 |
| institution | Kabale University |
| issn | 1601-5223 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Hereditas |
| spelling | doaj-art-52dc961d4e4e413fbb00c930616e87502025-08-20T03:47:14ZengBMCHereditas1601-52232025-06-0116211410.1186/s41065-025-00479-4Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in AsiaXiangyi Wu0Ren Cai1Mao Ye2Xitao Yang3Dachuan Sun4Yifeng Han5Xindong Fan6Jiaxue Zhu7Department of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Fengcheng Hospital Affiliated to Shanghai Ninth People’s Hospital, Shanghai Jiao Tong UniversityDepartment of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedics, Fengcheng Hospital Affiliated to Shanghai Ninth People’s Hospital, Shanghai Jiao Tong UniversityDepartment of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Interventional Therapy, Multidisciplinary Team of Vascular Anomalies, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of MedicineAbstract Refractory ulcers caused by high-flow arteriovenous malformations (AVMs) pose significant therapeutic challenges due to persistent tissue ischemia and shear stress-induced graft failure. Traditional embolization or flap reconstruction strategies often yield suboptimal outcomes, particularly in weight-bearing regions. We present a 28-year-old female with a non-healing dorsal foot AVM ulcer despite multiple embolizations and radical toe amputations. Genetic testing revealed a KRAS mutation, confirming a somatic etiology of AVM. After a debridement and local flap repair, we employed Ilizarov-assisted periosteal distraction to improve local perfusion. 75% of the wound epithelialized and the infection resolved within 4 weeks postoperatively, with granulation tissue covering the remainder. This case highlights the mechanobiological advantages of Ilizarov-based neovascular stimulation in AVM-related ischemic ulcers.https://doi.org/10.1186/s41065-025-00479-4Extracranial arteriovenous malformationIlizarov techniquePeriosteal distractionUlcer healingChemotherapy |
| spellingShingle | Xiangyi Wu Ren Cai Mao Ye Xitao Yang Dachuan Sun Yifeng Han Xindong Fan Jiaxue Zhu Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia Hereditas Extracranial arteriovenous malformation Ilizarov technique Periosteal distraction Ulcer healing Chemotherapy |
| title | Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia |
| title_full | Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia |
| title_fullStr | Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia |
| title_full_unstemmed | Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia |
| title_short | Ilizarov-assisted periosteal distraction for refractory arteriovenous malformation ulcers: first clinical report in Asia |
| title_sort | ilizarov assisted periosteal distraction for refractory arteriovenous malformation ulcers first clinical report in asia |
| topic | Extracranial arteriovenous malformation Ilizarov technique Periosteal distraction Ulcer healing Chemotherapy |
| url | https://doi.org/10.1186/s41065-025-00479-4 |
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