Intraoperative angiography in the management of pediatric vascular disorders.
We reviewed our experience with intraoperative angiography in the management of 7 cerebral aneurysms and 15 arteriovenous malformations (AVMs) in children over the past 5 years. The patients ranged from 4 months to 18 years of age with a mean age of 9 years. In 4 of the 22 cases, angiography provided information that led to changes during surgery. In 3 cases, the intraoperative angiogram revealed residual AVMs that were then completely resected. In 1 patient with an anterior circulation aneurysm, intraoperative studies revealed findings which resulted in clip repositioning. Intraoperative angiography added a mean of 43 (+/-19) min to the operative time, with a mode of 40 minutes. There was 1 complication, a groin hematoma that readily resolved. Intraoperative angiography prolongs to operative course; however, it is a useful adjunct to the management of vascular disorders in children. We now routinely use and recommend intraoperative angiography to assist with the surgical management of vascular malformations in children.
Ghosh
S
S
Division of Neurosurgery, Children's Hospital of Los Angeles, Los Angeles, Calif., USA.
Levy
M L
ML
Stanley
P
P
Nelson
M
M
Giannotta
S L
SL
McComb
J G
JG
D000293:Adolescent; D002533:Cerebral Angiography / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D002532:Intracranial Aneurysm / Q000601:surgery*; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D007430:Intraoperative Care; D012189:Retrospective Studies