Department of Surgery, University of Hong Kong, Pokfulam, Hong Kong.
Department of Neurosurgery, Ashikaga Red Cross Hospital, Tokyo, Japan.
J Neuroradiol. 2021 Mar;48(2):127-131. doi: 10.1016/j.neurad.2020.06.004. Epub 2020 Jun 27.
Macro-arteriovenous fistulas (MAVFs) are arteriovenous shunts draining into a giant venous ectasia. They can be treated by surgery or embolisation. Angiographic controls are usually performed rapidly after treatment in order to prove the cure of the lesion but no long term angiographies are generally scheduled. We wanted to control the stabilities of such lesions at follow-up.
Clinical history and imaging of ninety-five patients with high flow shunts draining into venous ectasias (MAVFs, Vein of Galen malformations and dilatations) were reviewed.
De novo arteriovenous shunts related to angiogenesis involving vasa vasorum developed in three patients with MAVFs at various intervals. Genetic underlying conditions as HHT or RASA 1 mutations were suspected in each patient.
Neo-angiogenesis can occur after cure of MAVFs. Long term imaging follow-ups should be considered as the natural history of such recurrent shunts is currently unknown.
动静脉瘘（MAVF）是指引流至巨大静脉扩张的动静脉分流。它们可以通过手术或栓塞来治疗。为了证明病变的治愈，治疗后通常会迅速进行血管造影检查，但通常不会安排长期血管造影检查。我们希望在随访中控制这些病变的稳定性。
回顾了 95 例高流量分流至静脉扩张（MAVF、Galen 静脉畸形和扩张）的患者的临床病史和影像学资料。
在 3 例 MAVF 患者中，在不同时间间隔出现了与血管生成有关的新的动静脉分流。每位患者均怀疑存在 HHT 或 RASA 1 突变等遗传基础疾病。
MAVF 治愈后可能会发生新的血管生成。由于此类复发性分流的自然史目前尚不清楚，应考虑进行长期影像学随访。
