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Endovascular treatment of congenital brain arteriovenous fistulas with combination of detachable coils and onyx liquid embolic agent

  • Interventional Neuroradiology
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Abstract

Introduction

Congenital brain arteriovenous fistulas (BAVFs) are rare vascular lesions, and conservative management was associated with a high mortality rate. We report our experience in the treatment of congenital BAVFs using detachable coils and Onyx liquid embolic agent.

Methods

Over the past 5 years, 15 patients with congenital BAVFs were treated endovascularly at our hospital using detachable coils and Onyx-34. All patients were clinically followed-up for 12–48 months. We retrospectively reviewed the medical records, cerebral angiograms, and endovascular reports for each patient.

Results

There were 15 patients with a total of 16 BAVFs (six men and nine women, with a mean age of 29.4 years). The clinical presentations were intracranial hemorrhage in six patients, headaches in four patients, and seizure in three patients, with two patients diagnosed incidentally. In all of the cases, transarterial microcatheterization was performed, 13 patients were treated with a combination of detachable coils and Onyx-34, and two with balloon-assisted coils and Onyx-34 embolization. There was no significant morbidity or mortality. All BAVF-related symptoms resolved immediately or gradually on clinical follow-up. Immediate angiographic obliteration was achieved in all patients. The fistulas remained closed in all patients, as ascertained by follow-up angiograms. No new neurological deficits related to the procedure were detected.

Conclusions

In our experience, the endovascular treatment of BAVFs with combination of detachable coils and Onyx is feasible, safe, and effective. This technique affords more control in the Onyx injection and minimizes the risk of distal embolization.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, 4th Affiliated hospital to Harbin Medical University, Harbin, People’s Republic of China, 150001

    Xuefeng Wang

  2. Department of Neurosurgery, Huashan Hospital, Fudan University, No.12, Wulumuqi Mid Road, Shanghai, 200040, People’s Republic of China

    Qihong Wang, Gong Chen, Bing Leng & Donglei Song

  3. Neurosurgical Department, Shanghai Medical College, Fudan University, Shanghai, 200032, People’s Republic of China

    Qihong Wang, Gong Chen, Bing Leng & Donglei Song

Authors
  1. Xuefeng Wang
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  2. Qihong Wang
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  3. Gong Chen
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  4. Bing Leng
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  5. Donglei Song
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Corresponding author

Correspondence to Qihong Wang.

Additional information

Contract grant sponsor: National Natural Science Foundation of China; contract grant number: 30872676

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Wang, X., Wang, Q., Chen, G. et al. Endovascular treatment of congenital brain arteriovenous fistulas with combination of detachable coils and onyx liquid embolic agent. Neuroradiology 52, 1121–1126 (2010). https://doi.org/10.1007/s00234-010-0681-x

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  • DOI: https://doi.org/10.1007/s00234-010-0681-x

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