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Child's Nervous System

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01-07-2010 | Original Paper

Perimedullary arteriovenous fistulas in pediatric patients: clinical, angiographical, and therapeutic experiences in a series of 19 cases

Authors: Xiaoli Meng, Hongqi Zhang, Yabing Wang, Ming Ye, Chuan He, Jianxin Du, Feng Ling

Published in: Child's Nervous System | Issue 7/2010

Abstract

Objective

The objective of this study was to review our pediatric series of perimedullary arteriovenous fistula (PMAVF), investigating the clinical characteristics, angioarchitecture, treatment strategy, and outcome of PMAVF in pediatric patients.

Methods and materials

Nineteen children with PMAVF treated in Xuanwu Hospital between 1986 and 2007 were reviewed. The demographic data, clinical symptoms, angiographical characteristics, classification, treatment modality, and outcome were compiled and analyzed. Clinical status was evaluated according to the modified Aminoff and Logue scale.

Results

In our pediatric series of PMAVF, the mean age of diagnosis was 8.1 years (range, 0.8–13.7 years). Male predominance was found in our series (M/F ratio, 3.75:1). Eleven children (57.9%) presented with acute onset of symptoms, and eight cases (42.1%) had progressive evolution of the diseases. In 13 cases (68.4%), the fistulas were classified as type III, with type II in six cases. Four lesions (21.1%) were located in the cervical region, with 15 lesions (78.9%) in thoracolumbar region. Ten cases (II = 2, III = 8) were treated with embolization, and nine (II = 4, III = 5) with combined embolization and complementary surgery. According to the criteria of therapeutic effectiveness, 31.6% of cases (6/19) were cured, and nine patients (47.4%) had improved.

Conclusions

PMAVFs in pediatric population exhibit many characteristics in clinical and angiographical aspects, need for special considerations. Most of PMAVFs in pediatric patients are high-flow fistulas, and endovascular embolization should be the first choice of treatment. After appropriate therapy, most of children can get satisfactory outcomes.

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Title: Perimedullary arteriovenous fistulas in pediatric patients: clinical, angiographical, and therapeutic experiences in a series of 19 cases
Authors: Xiaoli Meng
Hongqi Zhang
Yabing Wang
Ming Ye
Chuan He
Jianxin Du
Feng Ling
Publication date: 01-07-2010
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 7/2010
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-009-1071-8

At a glance: The STEP trials

Springer Medicine

Perimedullary arteriovenous fistulas in pediatric patients: clinical, angiographical, and therapeutic experiences in a series of 19 cases

Abstract

Objective

Methods and materials

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods and materials

Results

Conclusions

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