Spontaneous thrombosis of high flow pediatric arteriovenous fistulae: Case series of two patients and a comprehensive literature review

Karen S. Chen, Daniel Davila Williams, Ionela Iacobas, Samuel G. McClugage, Nisha Gadgil, Peter Kan

Research output: Contribution to journalReview articlepeer-review

Abstract

Pediatric pial arteriovenous shunts in the brain and spine are challenging to understand because of low incidence, variable presentation, and associations with genetic syndromes. What is known about their natural history comes from reviews of small series. To better understand the natural history and role for intervention, two cases are presented followed by a review of the literature. In the first case, an infant with a prior history of intracranial hemorrhage from a ruptured pial fistula returns for elective embolization for a second pial fistula which was found to be spontaneously thrombosed 2 weeks later. In the second case, a 5-year-old with a vertebro-vertebral fistula, identified on work up for a heart murmur and documented with diagnostic angiography, is brought for elective embolization 6 weeks later where spontaneous thrombosis is identified. In reviewing the literature on pediatric single-hole fistulae of the brain and spine, the authors offer some morphologic considerations for identifying which high-flow fistulae may undergo spontaneous thrombosis to decrease the potentially unnecessary risk associated with interventions in small children.

Original languageEnglish (US)
JournalChild's Nervous System
DOIs
StateAccepted/In press - 2023
Externally publishedYes

Keywords

  • Arteriovenous fistula
  • Arteriovenous shunt
  • Endovascular embolization
  • Natural history
  • Pediatric
  • Spinal shunt

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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