title: Endovascular Treatment of Two High-Flow Brain Arteriovenous Fistulas with a Combination of Detachable Coils and Onyx in an Infant: Case Report and Review of Literature.
abstract: Congenital brain arteriovenous fistulas (BAVFs) are rare neurovascular lesions of the brain, and few cases have been reported of their treatment with a combination of detachable coils and Onyx, especially in infants. Here, we present a case of 2 high-flow BAVFs occurring in a 12-month-old boy. Standard techniques of digital subtraction angiography were used, and dimethyl sulfoxide-compatible microcatheters were delivered and entered into a distal feeding artery as closely as possible to the fistulas. Then, a combination of detachable coils and Onyx was used. After the treatment of the 2 high-flow BAVFs, a complete percutaneous embolization of the fistulas was obtained. The fistulas remained closed, as ascertained by follow-up angiograms. No new neurological deficit related to the procedure was detected, and the infant was asymptomatic and in good health 4 years after the surgery. Our case shows that the endovascular treatment of high-flow BAVFs with a combination of detachable coils and Onyx in an infant is safe and effective.
authors.affiliation: Department of Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors.forename: Qihong
authors.initials: Q
authors.lastname: Wang
authors.forename: Zhe
authors.initials: Z
authors.lastname: Quan
authors.forename: ZhiQiang
authors.initials: Z
authors.lastname: Li
mesh_terms: D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging* / Q000628:therapy*; D002675:Child, Preschool; D004121:Dimethyl Sulfoxide / Q000008:administration & dosage*; D057510:Endovascular Procedures / Q000379:methods*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D011145:Polyvinyls / Q000008:administration & dosage*; D011859:Radiography; D013635:Tantalum / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: C000598428:Onyx 34; D011145:Polyvinyls; D013635:Tantalum; D004121:Dimethyl Sulfoxide