Endovascular treatment of intracranial high-flow arteriovenous fistulas by Guglielmi detachable coils.
BACKGROUND
This study reports our experience in performing transarterial Guglielmi detachable coil (GDC) embolization for intracranial high-flow arteriovenous fistulas (AVFs) and evaluates its efficacy and safety.


METHODS
Over 3 years, 13 patients with 14 intracranial high-flow AVFs had been managed by transarterial GDC embolization in our institution. There were 6 men and 7 women, with a mean age of 27 years. Of these 14 AVFs, 8 were traumatic carotid-cavernous fistulas (TCCFs); 5 were AVFs at the frontal, temporal, parieto-occipital lobes, or associated with arteriovenous malformation (n = 3); 1 was a tentorium AVF.


RESULTS
All of these high-flow AVFs were successfully occluded by a single session of transarterial GDC embolization. In 8 patients with TCCFs, the nearby parent arteries were preserved. The average number of coils was 8 and the average length was 126 cm. All AVF-related symptoms resolved immediately or gradually on clinical follow-up. No significant procedure-related neurologic complication or recurrent AVF was seen. All 13 patients were followed up clinically for an average of 16 months (range, 6-25 months).


CONCLUSIONS
Transarterial GDC embolization is a useful method in the treatment of intracranial high-flow AVFs. GDC affords more control in the placement of coils and proved both efficient and safe in the management of intracranial high-flow AVFs.
Department of Radiology, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taiwan, ROC. cbluo@vghtpe.gov.tw
Chao-Bao
CB
Luo
Michael Mu-Huo
MM
Teng
Feng-Chi
FC
Chang
Cheng-Yen
CY
Chang
D000293:Adolescent; D000328:Adult; D001164:Arteriovenous Fistula / Q000628:therapy*; D001921:Brain / Q000098:blood supply*; D002648:Child; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged