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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Interventional occlusion of congenital vascular malformations
Chun-Hong Xie1, Cheng-Sen Xia, Fang-Qi Gong
1Department of Cardiology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China. xch_hz@hotmail.com
Insights
Interventional occlusion using coils effectively manages congenital vascular malformations in children. This minimally invasive approach offers a safe alternative to surgery for various cardiac defects.
Area of Science:
- Cardiology
- Interventional Radiology
- Pediatric Surgery
Background:
- Congenital cardiac malformations require effective management strategies.
- Interventional occlusion has emerged as a novel approach for treating these conditions.
Purpose of the Study:
- To present the experience with interventional occlusion of congenital vascular malformations in pediatric patients.
- To evaluate the safety and efficacy of transcatheter coil embolization.
Main Methods:
- Retrospective review of 139 pediatric patients with congenital vascular malformations treated between 1997 and 2005.
- Analysis of pre-operative evaluation, procedural success, closure rates, and short-term outcomes.
Main Results:
- Successful deployment in 96% of patent ductus arteriosus cases (121/126).
- Achieved 100% closure rates for coronary artery fistula and pulmonary arteriovenous fistula after one month.
- 100% closure rates for pulmonary sequestration and aortopulmonary collaterals.
Conclusions:
- Transcatheter coil closure is a safe and effective alternative to surgical ligation for pediatric congenital vascular malformations.
- Appropriate coil selection is crucial for optimal patient outcomes.
Background:
New materials and devices have been used in the management of cardiac malformations. In this paper, we present our experience with interventional occlusion of congenital vascular malformations.
Methods:
Between January 1997 and December 2005, 139 patients with congenital vascular malformations who had undergone interventional occlusion in the Children's Hospital, Zhejiang University School of Medicine were studied. The clinical data of the patients were retrospectively reviewed including pre-operative evaluation, surgical procedures, immediate complete closure rate, short-term complications, and short-term outcome.
Results:
Of the 139 patients, 126 had patent ductus arteriosus, and successful deployment was achieved in 121 of the 126 patients (96%, 121/126). Six patients had coronary artery fistula and 14 different coils were used for embolization; the immediate complete closure rate was 83.3%, and the complete closure rate after one month was 100%. The abnormal vessels of 3 patients with pulmonary sequestration were completely occluded using four 0.038-inch Gianturco coils. In 3 patients with aortopulmonary collaterals, 14 abnormal vessel branches were occluded with sixteen 0.038-inch Gianturco coils, reaching a closure rate of 100%. One patient with pulmonary arteriovenous fistula was occluded successfully with two 0.038-inch Gianturco coils.
Conclusions:
Transcatheter closure using coils is a safe and effective alternative to surgical ligation in the management of congenital vascular malformations in children. Selection of appropriate coils is important to achieve a better outcome.
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