Ramsey Ashour1, Darren B Orbach. 1. aDepartment of Neurosurgery, Brigham and Women's Hospital bNeurointerventional Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE OF REVIEW: To highlight the spectrum of pediatric neurovascular conditions typically referred for diagnostic or interventional neuroangiography, the range of techniques available in contemporary pediatric neurointerventional practice, and the specific considerations relating to radiation and contrast dosing applicable to pediatric neurointerventional procedures. RECENT FINDINGS: Neurointerventional procedures are increasingly utilized in children for a variety of indications, with continuous emphasis on improving safety and treatment effectiveness. Numerous steps can be taken to mitigate the potential risks of pediatric neurointerventional procedures, with recent data from high-volume centers suggesting similar, if not lower, complication rates in children compared with adults. Judicious patient selection and clarity of goals are critically important, however, because children undergoing complex and lengthy neurointerventional procedures are particularly vulnerable to the effects of ionizing radiation, vessel injury, and contrast overload. SUMMARY: With continued advances in endovascular technology, neurointerventionalists stand to play an important and expanding role in the multidisciplinary management of pediatric neurovascular disease.
PURPOSE OF REVIEW: To highlight the spectrum of pediatric neurovascular conditions typically referred for diagnostic or interventional neuroangiography, the range of techniques available in contemporary pediatric neurointerventional practice, and the specific considerations relating to radiation and contrast dosing applicable to pediatric neurointerventional procedures. RECENT FINDINGS: Neurointerventional procedures are increasingly utilized in children for a variety of indications, with continuous emphasis on improving safety and treatment effectiveness. Numerous steps can be taken to mitigate the potential risks of pediatric neurointerventional procedures, with recent data from high-volume centers suggesting similar, if not lower, complication rates in children compared with adults. Judicious patient selection and clarity of goals are critically important, however, because children undergoing complex and lengthy neurointerventional procedures are particularly vulnerable to the effects of ionizing radiation, vessel injury, and contrast overload. SUMMARY: With continued advances in endovascular technology, neurointerventionalists stand to play an important and expanding role in the multidisciplinary management of pediatric neurovascular disease.