Embolization of Vascular Malformations at Institute for Diagnostic & Interventional Radiology in Frankfurt

The Institute for Diagnostic and Interventional Radiology at University Hospital Frankfurt provides a highly specialized medical program for the embolization of vascular malformations, encompassing both high-flow (arteriovenous malformations) and low-flow (venous and lymphatic malformations) lesions. The clinic utilizes a multidisciplinary approach to treat these complex, often congenital vascular anomalies that can cause pain, swelling, disfigurement, or functional impairment. The program integrates high-end diagnostic mapping with minimally invasive catheter-based interventions to provide either curative or palliative relief. Vascular malformations are structural abnormalities resulting from errors in vascular morphogenesis. At University Hospital Frankfurt, the treatment strategy is strictly determined by the lesion's flow characteristics. High-flow arteriovenous malformations (AVMs) are characterized by abnormal direct communications between arteries and veins without a capillary bed, which can lead to high-pressure symptoms and tissue ischemia. Low-flow venous or lymphatic malformations involve abnormally dilated and weak-walled vessels where blood pools, often leading to chronic pain or thrombosis. The embolization program aims to selectively shut down these abnormal channels while preserving the healthy surrounding blood supply. The embolization procedure is performed in the clinic’s state-of-the-art angiography suite, utilizing high-resolution 3D imaging and AI-supported fluoroscopy for precise navigation. Depending on the type of malformation, the interventional radiologist accesses the vascular system via a tiny puncture in the groin (femoral) or the arm (brachial/radial). Using a coaxial microcatheter technique, the team navigates to the "nidus," or core, of the malformation. For high-flow AVMs, liquid embolic agents like Onyx, Squid, or N-butyl cyanoacrylate (NBCA) are typically used to "plug" the abnormal connections. For low-flow venous lesions, percutaneous sclerotherapy, the injection of sclerosing agents like absolute ethanol or specialized foams directly into the malformation, is the preferred method to shrink the vessel tangle from the inside.