1Department of Neurosurgery, Complexo Hospital de Clinicas, Universidade Federal do Paraná-UFPR.
2Department of Neurosurgery, Hospital Pequeno Principe.
J Neurosurg Pediatr. 2020 Dec 18;27(3):364-367. doi: 10.3171/2020.7.PEDS20401. Print 2021 Mar 1.
Cerebral pial arteriovenous fistula (AVF) is a rare vascular malformation and may cause hemorrhage and neurological deficit. The presence of high-flow shunts constitutes a challenge when performing the endovascular technique, due to risk of distal embolization. The authors report a simple maneuver, adapted from the Matas test, that was successfully applied to treat a child with two pial AVFs.
An 8-year-old boy presented with headache and vomiting due to two single-channel high-flow intracerebral pial AVFs. He was treated with an endovascular approach using brief, gentle compression of the ipsilateral cervical carotid artery. The temporary flow arrest ensured proper placement of the first coil, allowing definitive obliteration of the shunt.
There were no complications with the procedure, and the patient recovered uneventfully. Throughout the 9-month follow-up, the patient experienced a stable neurological condition, with both fistulas occluded and improvement of local circulation.
This easy-to-perform maneuver allows precise positioning of embolic material into high-flow shunts to facilitate treatment of pial AVF.
脑皮层动静脉瘘（AVF）是一种罕见的血管畸形，可导致出血和神经功能缺损。由于存在高流量分流，因此在进行血管内治疗时会构成挑战，因为存在远端栓塞的风险。作者报告了一种简单的操作方法，该方法源自 Matas 试验，成功应用于治疗两名患有脑皮层 AVF 的儿童。
一名 8 岁男孩因两个单通道高流量颅内脑皮层 AVF 出现头痛和呕吐而就诊。使用短暂、轻柔地压迫对侧颈总动脉的血管内方法进行治疗。暂时的血流停止可确保适当放置第一个线圈，从而可以彻底闭塞分流。
该手术无并发症，患者恢复顺利。在 9 个月的随访过程中，患者的神经状况稳定，两个瘘均已闭塞，局部循环得到改善。
这种易于实施的操作方法可使栓塞材料精确地进入高流量分流，从而有助于治疗脑皮层 AVF。
