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Clinical features and endovascular treatment of intracranial arteriovenous malformations in pediatric patients

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Abstract

Purpose

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.

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Conflict of interest/disclosures

The authors declare that they have no financial or other conflicts of interest in relation to this research and its publication.

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Authors and Affiliations

  1. Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, Guangzhou, 510282, China

    Tao Zheng, Qiu-Jing Wang, Ya-Qi Liu, Xu-Bo Cui, Yu-Yuan Gao, Ling-Feng Lai, Shi-Xing Su, Xin Zhang, Xi-Feng Li, Xu-Ying He & Chuan-Zhi Duan

  2. The National Key Clinic Specialty; The Neurosurgery Institute of Guangdong Province, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Southern Medical University, Guangzhou, 510282, China

    Tao Zheng, Qiu-Jing Wang, Ya-Qi Liu, Xu-Bo Cui, Yu-Yuan Gao, Ling-Feng Lai, Shi-Xing Su, Xin Zhang, Xi-Feng Li, Xu-Ying He & Chuan-Zhi Duan

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  1. Tao Zheng
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Correspondence to Qiu-Jing Wang.

Additional information

Tao Zheng, Qiu-Jing Wang, and Ya-Qi Liu contributed equally to this work.

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Zheng, T., Wang, QJ., Liu, YQ. et al. Clinical features and endovascular treatment of intracranial arteriovenous malformations in pediatric patients. Childs Nerv Syst 30, 647–653 (2014). https://doi.org/10.1007/s00381-013-2277-3

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  • DOI: https://doi.org/10.1007/s00381-013-2277-3

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