|Title:||Prioritized venous coiling facilitating endovascular treatment of brain arteriovenous malformations with a fistulous component||Authors:||MENG-FAI KUO
|Issue Date:||2015||Journal Volume:||84||Journal Issue:||6||Start page/Pages:||1857-1863||Source:||World Neurosurgery||Abstract:||
Background Brain arteriovenous malformation (AVM) with a fistulous component presents a treatment challenge. The presence of the fistulous component may be related to either a complication from endovascular treatment, perioperative hemorrhagic events during surgical resection, or incomplete obliteration after radiosurgery. Case Description From December 2010 to May 2014, 7 consecutive patients (3 men, 4 women, average age, 28.7 years; age range, 11 months to 67 years) with AVMs with a high-flow fistulous component were treated at our institute with venous coiling before transarterial liquid embolization. One AVM was grade I based on the Spetzler-Martin grading system, 1 was grade II, 3 were grade III, and 2 were grade IV. The nidus size ranged from 1.7 to 6.0 cm. Four patients had pure fistulous-type lesions, and 3 had lesions of the mixed fistulous-plexiform type. All AVMs shared a common feature of a high-flow fistulous component with a large venous pouch emerging from the nidus. After endovascular embolization of the AVMs, 3 patients had complete occlusion, 3 patients had near-complete occlusion, and 1 patient had significant reduction in volume. There was no immediate complication after embolization, but 1 patient experienced delayed hemorrhage 3 days after the procedure. Conclusions Prioritized transarterial venous coiling is feasible for the embolization of AVMs with a high-flow fistulous component and the procedure had an acceptable complication rate. ? 2015 Elsevier Inc.
|DOI:||10.1016/j.wneu.2015.08.014||metadata.dc.subject.other:||adult; aged; Article; artificial embolism; brain arteriovenous malformation; brain hemorrhage; child; clinical article; clinical feature; coil embolization; disease classification; female; fistula; follow up; human; infant; male; middle aged; preschool child; school child; adolescent; arteriovenous fistula; artificial embolization; brain angiography; endovascular surgery; feasibility study; Intracranial Arteriovenous Malformations; pathology; procedures; radiosurgery; severity of illness index; treatment outcome; Adolescent; Adult; Aged; Arteriovenous Fistula; Cerebral Angiography; Child; Child, Preschool; Embolization, Therapeutic; Endovascular Procedures; Feasibility Studies; Female; Humans; Infant; Intracranial Arteriovenous Malformations; Male; Middle Aged; Radiosurgery; Severity of Illness Index; Treatment Outcome
|Appears in Collections:||醫學系|
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.