Total endovascular occlusion of a giant direct arteriovenous fistula in the posterior fossa in a case of Rendu-Osler-Weber disease

We report a case of giant single-hole direct arteriovenous fistula (AVF) located in the posterior fossa of a child with Rendu-Osler-Weber disease (ROW). There is neither a clinical nor an angioarchitectural difference between AVFs associated with ROW and sporadic AVFs, but ROW should be suspected in...

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Bibliographic Details
Published in:Child's nervous system 1996-12, Vol.12 (12), p.785-788
Main Authors: COUBES, P, HUMBERTCLAUDE, V, RODESCH, G, LASJAUNIAS, P, ECHENNE, B, FREREBEAU, P
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Cerebral Angiography
Cranial Fossa, Posterior - blood supply
Embolization, Therapeutic
Female
Follow-Up Studies
Humans
Intracranial Arteriovenous Malformations - diagnosis
Intracranial Arteriovenous Malformations - genetics
Intracranial Arteriovenous Malformations - therapy
Magnetic Resonance Imaging
Medical sciences
Neurologic Examination
Neurology
Telangiectasia, Hereditary Hemorrhagic - diagnosis
Telangiectasia, Hereditary Hemorrhagic - genetics
Telangiectasia, Hereditary Hemorrhagic - therapy
Vascular diseases and vascular malformations of the nervous system
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Summary:We report a case of giant single-hole direct arteriovenous fistula (AVF) located in the posterior fossa of a child with Rendu-Osler-Weber disease (ROW). There is neither a clinical nor an angioarchitectural difference between AVFs associated with ROW and sporadic AVFs, but ROW should be suspected in children with multifocal pial AVFs. Transarterial embolization was performed to obliterate the AVF in a unique procedure using simultaneous bifemoral catheterization. At follow up 4 years later, the clinical examination was normal. Control MR scans and angiography showed the total occlusion of the fistula, permanent thrombosis of the venous pouch, and disappearance of the abnormal venous drainage. In this case, the endovascular procedure was available and we estimated that it represented a lesser risk than the surgical approach (risk of hemorrhage and risk of thrombosis involving the feeding arteries and the brain stem venous drainage). Furthermore, it avoids craniotomy and reduces the duration of hospitalization.
ISSN:0256-7040
1433-0350
DOI:10.1007/bf00261599