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J Neurosurg Pediatr. 2011 Jun;7(6):637-42. doi: 10.3171/2011.4.PEDS10577.

Balloon-assisted Onyx embolization of cerebral single-channel pial arteriovenous fistulas.

Author information

  • 1Division of Neurosurgery, University of California-San Diego, CA, USA.

Abstract

OBJECT:

Pial arteriovenous fistulas (AVFs) of the brain are rare vascular malformations associated with significant risks of hemorrhage and neurological deficit. Depending on their location and high-flow dynamics, these lesions can present treatment challenges for both endovascular and open cerebrovascular surgeons. The authors describe a novel endovascular treatment strategy that was used successfully to treat 2 pediatric patients with a pial AVF, and they discuss the technical nuances specific to their treatment strategy.

METHODS:

A single-channel high-flow pial AVF was diagnosed in 2 male patients (6 and 17 years of age). Both patients were treated with endovascular flow arrest using a highly conformable balloon followed by Onyx infusion for definitive closure of the fistula.

RESULTS:

Neither patient suffered a complication as a result of the procedure. At the 6-month follow-up in both cases, the simple discontinuation of blood flow had resulted in durable obliteration of the fistula and stable or improved neurological function.

CONCLUSIONS:

Onyx can be delivered successfully into high-flow lesions after flow arrest to allow a minimally invasive and durable treatment for pial AVFs.

PMID:
21631202
[PubMed - indexed for MEDLINE]

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