title: Coil-based endovascular treatment of single-hole cerebral arteriovenous fistulae: experiences in 11 patients.
abstract: BACKGROUND
  An SHF is rare pial arteriovenous shunt with no nidal component, of which the feeder drains directly into a single venous channel. Casting with NBCA was described previously, but its control demands operator to accumulate a considerable learning curve. We are to present our experiences of coil-based endovascular treatment of SHF.
  
  
  METHODS
  Eleven patients harbored 12 SHFs (5 men, 6 women; mean age, 28.4 years; age range, 4-73 years), and they presented with hemorrhage, seizure, collapse, orbital mass, and as an incidental lesion. The location was frontal for 3, temporal for 5, parietal in 2, and occipital in 2 patients. The angioarchitectures, the methods of endovascular treatment, and outcomes were analyzed.
  
  
  RESULTS
  Fifteen feeders arose from 4 anterior, 8 middle, and 3 posterior cerebral arteries. The coil framework was constructed at the fistula before the penetration of a low concentrated NBCA. Nine fistulae were occluded completely, and 3 fistulae were occluded to near-completion with micro-AVM. There was no recanalization of SHF, either growth of a micro-AVM during follow-up period (mean, 48.3 months; range, 6-120 months). One patient with postprocedure hemorrhage developed hemiplegia, but 1 patient with seizure and the other 9 asymptomatic patients were uneventful.
  
  
  CONCLUSIONS
  The coil-based endovascular treatment can achieve safe and stable occlusion of SHF, and the preventions against venous thrombosis and perfusion breakthrough should be essential.
authors.affiliation: Department of Radiology, Korea University Anam Hospital, Seoul, South Korea. liberobh@empal.com
authors.forename: Sung Won
authors.initials: SW
authors.lastname: Youn
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
authors.forename: Bae Ju
authors.initials: BJ
authors.lastname: Kwon
authors.forename: Hyun-Seung
authors.initials: HS
authors.lastname: Kang
authors.forename: Hyuk Won
authors.initials: HW
authors.lastname: Chang
authors.forename: Bum-Soo
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017130:Angioplasty; D001164:Arteriovenous Fistula / Q000150:complications / Q000473:pathology / Q000628:therapy*; D002543:Cerebral Hemorrhage / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000473:pathology / Q000628:therapy*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult