title: Surgical flow disconnection of cerebral pial dual-channel arteriovenous fistula with a large varix: the role of anti-platelet agent or anti-coagulation therapy.
abstract: BACKGROUND
  Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion, and the literature is sparse. Most authors insist that simple disconnection of arteriovenous shunting is enough to treat intracral single-channel pial AVF in most cases, either by microsurgery or endovascular embolization without resection of entire vascular malformation.
  
  
  CONCLUSIONS
  We report an insidious onset of peri-lesional edema formation after abrupt disconnection of AVF shunting with surgical arterial ligation. Treatment entailed anti-platelet and anti-coagulation agent to slow down thrombus formation in intracranial dual-channel pial AVF. We suggest that slowing down thrombus formation in the large varix with anti-platelet and/or anti-coagulation agents seems to be necessary in case of abrupt disconnection of shunting in intracranial single- or dual-channel pial AVF to prevent postoperative cerebral edema or infarction.
authors: Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 166 Gumi-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, Korea.
authors: Jeyul
authors: J
authors: Yang
authors: O-Ki
authors: OK
authors: Kwon
authors: Chang Wan
authors: CW
authors: Oh
authors: Gyojun
authors: G
authors: Hwang
authors: Kyung Sun
authors: KS
authors: Song
authors: Young Jin
authors: YJ
authors: Lee
authors: Jae Seung
authors: JS
authors: Bang
mesh_terms: D000293:Adolescent; D000925:Anticoagulants / Q000627:therapeutic use*; D001164:Arteriovenous Fistula / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D010841:Pia Mater / Q000601:surgery*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
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