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Coil-based endovascular treatment of single-hole cerebral arteriovenous fistulae: experiences in 11 patients.
MedLine Citation:
PMID:  19665176     Owner:  NLM     Status:  Publisher    
BACKGROUND: An SHF is rare pial arteriovenous shunt with no nidal component, of which the feeder drains directly into a single venous channel. Casting with NBCA was described previously, but its control demands operator to accumulate a considerable learning curve. We are to present our experiences of coil-based endovascular treatment of SHF. METHODS: Eleven patients harbored 12 SHFs (5 men, 6 women; mean age, 28.4 years; age range, 4-73 years), and they presented with hemorrhage, seizure, collapse, orbital mass, and as an incidental lesion. The location was frontal for 3, temporal for 5, parietal in 2, and occipital in 2 patients. The angioarchitectures, the methods of endovascular treatment, and outcomes were analyzed. RESULTS: Fifteen feeders arose from 4 anterior, 8 middle, and 3 posterior cerebral arteries. The coil framework was constructed at the fistula before the penetration of a low concentrated NBCA. Nine fistulae were occluded completely, and 3 fistulae were occluded to near-completion with micro-AVM. There was no recanalization of SHF, either growth of a micro-AVM during follow-up period (mean, 48.3 months; range, 6-120 months). One patient with postprocedure hemorrhage developed hemiplegia, but 1 patient with seizure and the other 9 asymptomatic patients were uneventful. CONCLUSIONS: The coil-based endovascular treatment can achieve safe and stable occlusion of SHF, and the preventions against venous thrombosis and perfusion breakthrough should be essential.
Sung Won Youn; Moon Hee Han; Bae Ju Kwon; Hyun-Seung Kang; Hyuk Won Chang; Bum-Soo Kim
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2009-8-6
Journal Detail:
Title:  Surgical neurology     Volume:  -     ISSN:  1879-3339     ISO Abbreviation:  Surg Neurol     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-8-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Radiology, Korea University Anam Hospital, Seoul 136-705, South Korea.
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