Clinical observation of endovascular embolization for the treatment of pial arteriovenous fistula
10.3969/j.issn.1672-5921.2019.08.005
- Author:
Zongfei JIANG
1
Author Information
1. Department of Neurosurgery, Jinan City People's Hospital
- Publication Type:Journal Article
- Keywords:
Balloon;
Endovascular treatment;
Pial arteriovenous fistula
- From:
Chinese Journal of Cerebrovascular Diseases
2019;16(8):416-422
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics, imaging features and treatment strategies of pial arteriovenous fistula. Methods From January 2013 to December 2017,12 patients with pial arteriovenous fistula confirmed by cerebral angiography and received treatment at the Department of Neurosurgery,Xuanwu Hospital, Capital Medical University were retrospectively recruited. All patients underwent endovascular embolization with Glubran 2,coil + Glubran 2 or Onyx 18. Some patients underwent balloon-assisted embolization. The embolization effect (complete occlusion,subtotal occlusion,partial occlusion) and postoperative complications were observed. Patients were followed up to evaluate symptom relief and radiological outcomes (previous lesions not visualized by re-examination imaging). Results For the initial symptoms,there were 6 headaches, 3 seizures,2 intracranial hemorrhages, and 1 tinnitus. After embolization, 11 patients had complete occlusion of the fistula and One patient had subtotal occlusion. Six patients underwent balloon-assisted embolization. One patient developed a decrease in muscle strength in the left limb after embolization. There were no deaths. Eleven patients completed the followup. The median follow-up time was 13. 4 (5. 2,26. 7) months. Nine patients had symptoms disappeared. One patient still had headache and 1 patient received oral antiepileptic drugs to control seizures. The fistulas were not visualized by angiopathy in all 11 patients. One patient developed dural arteriovenous fistula and arteriovenous malformation in superior sagittal sinus, straight sinus and sinus confluence. The patient was cured by embolization. Conclusions Pial arteriovenous fistula is a rare clinical disease, which is often characterized by headache, seizure, etc. Endovascular therapy is a safe and effective treatment method.
