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Single-center experience with endovascular treatment of cerebral arteriovenous malformations with intent to cure in pediatric patients

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Abstract

Purpose

This study aimed to report the incidence of technical complications and immediate complete angiographic occlusion, identify associated factors with failure of complete occlusion and identify predictors of technical complications in a single-center experience of pediatric arteriovenous malformations (AVM) treated with endovascular treatment with intent to cure.

Methods

Patients between 1 and 18 years of age undergoing endovascular embolization between 2011 and 2020 were included.

Results

A total of 120 embolizations were performed in 69 patients. The most frequent clinical presentation was intracerebral hemorrhage (76.8%). Immediate obliteration of the malformations was achieved in 40 (58%) cases. The technical complication rate was 15%. AVM nidus size between 3 and 6 cm (OR: 3.91; 95% CI 1.1–13.85; p = 0.035) and the presence of multiple feeders (OR: 5.08; 95% CI 1.41–18.28; p = 0.074) were predictive of failure of immediate complete occlusion. The location of the temporal lobe (OR: 7.83; p = 0.048), deep venous drainage (OR: 4.67; p = 0.112), and the presence of an intranidal aneurysm (OR: 3.58; p = 0.134) were predictors of technical complications.

Conclusions

Embolization of pediatric AVMs with intent to cure shows a high rate of technical complications and acceptable immediate occlusion rates. Nidus size and the presence of multiple feeders were predictive of failure of complete occlusion, while temporal lobe location, deep venous drainage, and the presence of an intranidal aneurysm were predictors of technical complications. Further studies are needed to determine the best therapeutic approach in the pediatric population.

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Authors and Affiliations

  1. Grupo Estudiantil de Investigación en Neurociencias, Sociedad Científica de Estudiantes de Medicina de la Universidad de San Martín de Porres, Lima, Peru

    Aaron Rodriguez-Calienes, Diego Bustamante-Paytan & Angie Mayoria-Vargas

  2. Facultad de Medicina Humana, Universidad de San Martín de Porres, Alameda del Corregidor 1531, La Molina 15024, Lima, Peru

    Aaron Rodriguez-Calienes, Diego Bustamante-Paytan & Angie Mayoria-Vargas

  3. Facultad de Medicina Humana, Universidad Científica del Sur, Lima, Peru

    Kiara Camacho-Caballero

  4. CHANGE, Research Working Group, Carrera de Medicina Humana, Universidad Cientifica del Sur, Lima, Peru

    Kiara Camacho-Caballero

  5. Department of Neurosurgery, Endovascular Neurosurgery Service, Hospital Nacional Guillermo Almenara Irigoyen, Lima, Peru

    Rodolfo Rodríguez-Varela & Giancarlo Saal-Zapata

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  1. Aaron Rodriguez-Calienes
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  2. Diego Bustamante-Paytan
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Correspondence to Diego Bustamante-Paytan.

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The present study was approved by the institutional review board of our institution under code 102345.

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Rodriguez-Calienes, A., Bustamante-Paytan, D., Camacho-Caballero, K. et al. Single-center experience with endovascular treatment of cerebral arteriovenous malformations with intent to cure in pediatric patients. Childs Nerv Syst 38, 343–351 (2022). https://doi.org/10.1007/s00381-021-05376-5

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