Document Detail

Coil-based endovascular treatment of single-hole cerebral arteriovenous fistulae: experiences in 11 patients.
MedLine Citation:
PMID:  20452863     Owner:  NLM     Status:  MEDLINE    
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:  2009-08-07
Journal Detail:
Title:  World neurosurgery     Volume:  73     ISSN:  1878-8750     ISO Abbreviation:  World Neurosurg     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-05-10     Completed Date:  2010-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101528275     Medline TA:  World Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2-10; discussion e1     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 Elsevier Inc. All rights reserved.
Department of Radiology, Korea University Anam Hospital, Seoul, South Korea.
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MeSH Terms
Arteriovenous Fistula / complications,  pathology,  therapy*
Cerebral Hemorrhage / etiology,  pathology,  therapy*
Child, Preschool
Cohort Studies
Embolization, Therapeutic*
Intracranial Arteriovenous Malformations / complications,  pathology,  therapy*
Retrospective Studies
Treatment Outcome
Young Adult

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