Jones Jesse George Atherton, Deveikis John
Radiology and Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Interv Neuroradiol. 2024 Aug 25:15910199241275710. doi: 10.1177/15910199241275710.
Pediatric arteriovenous shunts can be challenging to embolize and the consequences of excess venous penetration disastrous. Moreover, the congenital nature of most shunts necessitates neonatal intervention whenever (medically refractory) heart failure occurs. Here, we describe current endovascular treatment strategies based on personal experience and literature review. While disparate, arteriovenous malformation, dural arteriovenous fistula (AVF), pial AVF, and vein of Galen aneurysmal malformation share unifying features such as high output heart failure and venous hypertension. This tutorial is divided into passages on Goals, Access, and Treatment which respect differences among pediatric arteriovenous shunts while maintaining a narrative economy.
小儿动静脉分流的栓塞治疗具有挑战性,过度的静脉穿透会带来灾难性后果。此外,大多数分流的先天性本质使得一旦(药物治疗无效的)心力衰竭发生,就需要进行新生儿干预。在此,我们根据个人经验和文献综述描述当前的血管内治疗策略。虽然动静脉畸形、硬脑膜动静脉瘘(AVF)、软脑膜AVF和大脑大静脉动脉瘤样畸形各不相同,但它们具有一些共同特征,如高输出量心力衰竭和静脉高压。本教程分为目标、入路和治疗等章节,在保持叙述简洁的同时,兼顾了小儿动静脉分流之间的差异。