title: Clinical features and endovascular treatment of intracranial arteriovenous malformations in pediatric patients.
abstract: OBJECTIVE
  The purpose of this study was to characterize clinical features and evaluate the clinical outcome of endovascular embolization treatment intracranial arteriovenous malformations in pediatric patients.
  
  
  METHODS
  A cohort of children (age ≤ 18 years) with arteriovenous malformations (AVMs) from 2000 to 2012 was included. Predictors studied included patient gender, age, and angioarchitectural features, including AVM location, nidus morphology and size, venous drainage, and associated aneurysms. Treatment method, complications and outcomes were recorded. The features of AVMs were evaluated before the treatment.
  
  
  RESULTS
  One hundred twenty-seven children (77 males, mean age 13.2 years) were included; 90/127 (70.9 %) children were presented with hemorrhage. AVM size and deep venous drainage were independently associated with hemorrhage; 66/127 patients (52 %) treated with endovascular embolization. Complete obliteration at the end of all endovascular procedures was achieved in 14/66 patients (21.2 %), with an average of 78 % (range, 20-100 %) volume reduction. A mean of 2.9 (range, 1-9) feeding pedicles was embolized per patient. Overall, nine complications occurred in a total of 123 procedures (7.3 %). There was no procedure-related death in this study population. There was no significant difference between patients with and without complications in terms of AVM grade, demographic characteristics, or embolization features.
  
  
  CONCLUSIONS
  AVM size and deep venous drainage were independently associated with hemorrhage in pediatric patients. Endovascular procedure is feasible and safe for pediatric AVMs, and complete embolization can be achieved in small AVMs, while large AVMs can be adequately reduced in size for additional microsurgery or stereotactic radiosurgery.
authors.affiliation: Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Zheng
authors.forename: Qiu-Jing
authors.initials: QJ
authors.lastname: Wang
authors.forename: Ya-Qi
authors.initials: YQ
authors.lastname: Liu
authors.forename: Xu-Bo
authors.initials: XB
authors.lastname: Cui
authors.forename: Yu-Yuan
authors.initials: YY
authors.lastname: Gao
authors.forename: Ling-Feng
authors.initials: LF
authors.lastname: Lai
authors.forename: Shi-Xing
authors.initials: SX
authors.lastname: Su
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Li
authors.forename: Xu-Ying
authors.initials: XY
authors.lastname: He
authors.forename: Chuan-Zhi
authors.initials: CZ
authors.lastname: Duan
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000601:surgery*; D008297:Male; D044583:Neuroendoscopy / Q000379:methods; D012189:Retrospective Studies