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...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiangyi Wu, Ren Cai, Mao Ye, Xitao Yang, Dachuan Sun, Yifeng Han, Xindong Fan, Jiaxue Zhu
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Hereditas
Subjects:
Online Access:https://doi.org/10.1186/s41065-025-00479-4
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1601-5223