Endovascular Treatment of Intracranial High-flow Arteriovenous Fistulas by Guglielmi Detachable Coils

• Published in: Journal of the Chinese Medical Association Vol. 69; no. 2; pp. 80 - 85
• Main Authors: Luo, Chao-Bao, Teng, Michael Mu-Huo, Chang, Feng-Chi, Chang, Cheng-Yen
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2006
• Subjects: Adolescent; Adult; Arteriovenous Fistula - therapy; Brain - blood supply; Child; embolization; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Female; Guglielmi detachable coil; Humans; intracranial arteriovenous fistula; Male; Middle Aged; embolization; intracranial arteriovenous fistula; Guglielmi detachable coil
• ISSN: 1726-4901; 1728-7731
• DOI: 10.1016/S1726-4901(09)70118-2

This study reports our experience in performing transarterial Guglielmi detachable coil (GDC) embolization for intracranial high-flow arteriovenous fistulas (AVFs) and evaluates its efficacy and safety. Over 3 years, 13 patients with 14 intracranial high-flow AVFs had been managed by transarterial GDC embolization in our institution. There were 6 men and 7 women, with a mean age of 27 years. Of these 14 AVFs, 8 were traumatic carotid-cavernous fistulas (TCCFs); 5 were AVFs at the frontal, temporal, parieto-occipital lobes, or associated with arteriovenous malformation ( n = 3); 1 was a tentorium AVF. All of these high-flow AVFs were successfully occluded by a single session of transarterial GDC embolization. In 8 patients with TCCFs, the nearby parent arteries were preserved. The average number of coils was 8 and the average length was 126 cm. All AVF-related symptoms resolved immediately or gradually on clinical follow-up. No significant procedure-related neurologic complication or recurrent AVF was seen. All 13 patients were followed up clinically for an average of 16 months (range, 6–25 months). Transarterial GDC embolization is a useful method in the treatment of intracranial high-flow AVFs. GDC affords more control in the placement of coils and proved both efficient and safe in the management of intracranial high-flow AVFs.