Ryuya Maejima1, Tomotaka Ohshima2, Shigeru Miyachi3, Naoki Matsuo1, Reo Kawaguchi1, Masakazu Takayasu1. 1. Department of Neurosurgery, Aichi Medical University, Aichi, Nagakute, Japan. 2. Neuroendovascular Therapy Center, Aichi Medical University, Aichi, Nagakute, Japan. Electronic address: tmtkoh@gmail.com. 3. Neuroendovascular Therapy Center, Aichi Medical University, Aichi, Nagakute, Japan.
Abstract
BACKGROUND: Pial arteriovenous fistulas (PAVFs) are rare vascular malformations, especially in neonates. The purpose of this report is to discuss the treatment strategy and its associated challenges. We present a case of prenatal intracranial PAVF treated by endovascular embolization in the neonatal period. CASE DESCRIPTION: The patient was born through Cesarean delivery and then treated twice using transarterial embolization with detachable platinum coils and n-butyl cyanoacrylate due to intractable heart failure. Even though angiography findings showed dramatical reduction in the shunt, the patient did not recover from heart failure and died at day 49 after birth. CONCLUSIONS: Despite current developments in medical technology and therapies, the effective treatment of critical PAVFs still poses a challenge. Therefore, more indications and effective alternative treatments must be discussed.
BACKGROUND: Pial arteriovenous fistulas (PAVFs) are rare vascular malformations, especially in neonates. The purpose of this report is to discuss the treatment strategy and its associated challenges. We present a case of prenatal intracranial PAVF treated by endovascular embolization in the neonatal period. CASE DESCRIPTION: The patient was born through Cesarean delivery and then treated twice using transarterial embolization with detachable platinum coils and n-butyl cyanoacrylate due to intractable heart failure. Even though angiography findings showed dramatical reduction in the shunt, the patient did not recover from heart failure and died at day 49 after birth. CONCLUSIONS: Despite current developments in medical technology and therapies, the effective treatment of critical PAVFs still poses a challenge. Therefore, more indications and effective alternative treatments must be discussed.