Limitations and technical considerations of endovascular treatment in neonates with high-flow arteriovenous shunts presenting with congestive heart failure: report of two cases.
METHODS
We report two neonatal patients with high-flow intracranial or cervical arteriovenous (AV) shunts who presented with congestive heart failure and were successfully managed with endovascular treatment. One with vein of Galen malformation with body weight of only 2.0 kg is, to our knowledge, the smallest neonate successfully treated with endovascular treatment. The other neonate is, to our knowledge, the first vertebro-vertebral fistula patient presenting with heart failure and treated successfully with endovascular treatment.


CONCLUSIONS
Even in neonates, endovascular treatment is the procedure of choice for high-flow AV shunts presenting with progressive congestive heart failure resistant to medical management. We discuss limitations and technical considerations of endovascular treatments in small neonates with high-flow AV shunts and congestive heart failure.
Nakano
Shinichi
S
Division of Neuroradiology, Department of Medical Imaging, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada. snakano@fc.miyazaki-u.ac.jp
Agid
Ronit
R
Klurfan
Paula
P
dos Santos Souza
Marlise Peruzzo
MP
Armstrong
Derek
D
Terbrugge
Karel G
KG
D001166:Arteriovenous Shunt, Surgical; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic; D005500:Follow-Up Studies; D006333:Heart Failure / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D006801:Humans; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods