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American Journal of Neuroradiology, Vol 13, Issue 6 1571-1579, Copyright © 1992 by American Society of Neuroradiology


ARTICLES

Delayed venous occlusion following embolotherapy of vascular malformations in the brain

GR Duckwiler, JE Dion, F Vinuela and A Reichman
Department of Radiological Services, UCLA School of Medicine 90024.

PURPOSE: To describe the nature and features of delayed venous thrombosis following embolization of arteriovenous fistulae. METHODS: Retrospective review of the available clinical history, details of embolization procedures, and results of follow-up angiography were carried out on all embolization procedures performed on high-flow vascular malformations of the brain done at our institution since 1987. RESULTS: Four patients were identified who had delayed (greater than 1 week) venous thrombosis/occlusion after embolization of the malformation associated with neurologic complications. Two patients had arteriovenous fistula and two had vein-of-Galen malformations. These patients had no untoward embolization of the venous outlet as a cause of the venous occlusion. CONCLUSIONS: It is postulated that thrombosis in the arteriovenous fistula group was induced by conversion (due to embolization) of a patulous high flow venous outlet into a slow flow system; in the vein-of-Galen group, the occlusion was thought to be due to high-flow venopathy.


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