Details

Autor(en) / Beteiligte

• Rodriguez-Calienes, Aaron
• Bustamante-Paytan, Diego
• Camacho-Caballero, Kiara
• Mayoria-Vargas, Angie
• Rodríguez-Varela, Rodolfo
• Saal-Zapata, Giancarlo

Titel

Single-center experience with endovascular treatment of cerebral arteriovenous malformations with intent to cure in pediatric patients

Ist Teil von

• Child's nervous system, 2022-02, Vol.38 (2), p.343-351

Ort / Verlag

Berlin/Heidelberg: Springer Berlin Heidelberg

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Purpose This study aimed to report the incidence of technical complications and immediate complete angiographic occlusion, identify associated factors with failure of complete occlusion and identify predictors of technical complications in a single-center experience of pediatric arteriovenous malformations (AVM) treated with endovascular treatment with intent to cure. Methods Patients between 1 and 18 years of age undergoing endovascular embolization between 2011 and 2020 were included. Results A total of 120 embolizations were performed in 69 patients. The most frequent clinical presentation was intracerebral hemorrhage (76.8%). Immediate obliteration of the malformations was achieved in 40 (58%) cases. The technical complication rate was 15%. AVM nidus size between 3 and 6 cm (OR: 3.91; 95% CI 1.1–13.85; p  = 0.035) and the presence of multiple feeders (OR: 5.08; 95% CI 1.41–18.28; p  = 0.074) were predictive of failure of immediate complete occlusion. The location of the temporal lobe (OR: 7.83; p  = 0.048), deep venous drainage (OR: 4.67; p  = 0.112), and the presence of an intranidal aneurysm (OR: 3.58; p  = 0.134) were predictors of technical complications. Conclusions Embolization of pediatric AVMs with intent to cure shows a high rate of technical complications and acceptable immediate occlusion rates. Nidus size and the presence of multiple feeders were predictive of failure of complete occlusion, while temporal lobe location, deep venous drainage, and the presence of an intranidal aneurysm were predictors of technical complications. Further studies are needed to determine the best therapeutic approach in the pediatric population.