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. Copyright (c) 2010 Elsevier Inc. All rights reserved.
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. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Authors: André Lima Batista; Diego Gutierrez Romero; Jean-Christophe Gentric; Alain Weill; Jean Raymond; Daniel Roy Journal: Interv Neuroradiol Date: 2015-06-25 Impact factor: 1.610