First Line Onyx Embolization in Ruptured Pediatric Arteriovenous Malformations Safety and Efficacy

被引：5

作者：

Alias, Quentin ^{[1
]}

Boulouis, Gregoire ^{[1
,2
]}

Blauwblomme, Thomas ^{[3
,4
]}

Benichi, Sandro ^{[3
,4
]}

Beccaria, Kevin ^{[3
,4
]}

Gariel, Florent ^{[1
,2
,3
,4
,5
]}

Garzelli, Lorenzo ^{[1
]}

Meyer, Philippe ^{[6
]}

Kossorotoff, Manoelle ^{[7
]}

Boddaert, Nathalie ^{[1
]}

Brunelle, Francis ^{[1
]}

Naggara, Olivier ^{[1
,2
]}

机构：

[1] Necker Children Hosp, Pediat Radiol, Paris, France

[2] Univ Paris, Dept Neuroradiol, CHSA, INSERM,UMR 1266,IMA BRAIN, Paris, France

[3] Necker Children Hosp, AP HP, Pediat Neurosurg Dept, Paris, France

[4] Univ Paris, Inst Imagine, INSERM, UMR 1163, Paris, France

[5] Univ Hosp Bordeaux, Dept Neuroradiol, Bordeaux, France

[6] Necker Children Hosp, AP HP, Pediat Neuro ICU, Paris, France

[7] Univ Necker Children Hosp, AP HP, French Ctr Pediat Stroke, Dept Pediat Neurol, Paris, France

来源：

CLINICAL NEURORADIOLOGY | 2021年 / 31卷 / 01期

关键词：

Interventional neuroradiology; Pediatrics; Endovascular treatment; Hemorrhagic stroke; Intracerebral hemorrhage; HEMORRHAGE; CHILDREN; LESIONS; SYSTEM;

D O I：

10.1007/s00062-019-00861-6

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Purpose Brain arteriovenous malformations (bAVM) are the main cause of pediatric intracerebral hemorrhage (pICH). Embolization with Onyx (ev3, Irvine, CA, USA) in children with ruptured bAVM has been infrequently reported. The aim of this study was to assess the safety and efficacy profile of Onyx embolization as first line endovascular treatment of ruptured pediatric bAVMs. Methods Children with non-traumatic pICH due to bAVM rupture at a pediatric quaternary care center were prospectively enrolled in a registry and retrospectively analyzed between 2013 and 2018. Clinical and demographic data, treatment modalities and clinical imaging follow-up were retrieved, and detailed procedural data were retrospectively assessed by two investigators. The safety (procedural morbidity and mortality) and efficacy (obliteration and interval rebleeding) were evaluated. Results In this study 29 children treated for a bAVM by Onyx embolization were included (14 girls, 48%; median age 11.1 years, interquartile range, IQR 8.1-12.7 years) with a total of 72 endovascular sessions (median of 2 sessions per patient IQR 1-3). The AVMs were deeply located in 23 patients (79%). No systemic complications occurred, and no child experienced embolization-related persistent neurological deficits. Non-clinically relevant complications were observed during five procedures, unrelated to Onyx. After a mean follow-up of 31 months from rupture complete obliteration rates were 100%, 89%, 29%, 14% in bAVM Spetzler Martin grades I, II, III and IV-V, respectively. Conclusion It was found that Onyx embolization is safe and represents a good option for an initial treatment approach, in a sequential treatment strategy for pediatric ruptured brain AVMs. Younger age may not be an argument to deny Onyx embolization.

引用

页码：155 / 163

页数：9