Limitations and technical considerations of endovascular treatment in neonates with high-flow arteriovenous shunts presenting with congestive heart failure: report of two cases |
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| Authors: | Shinichi Nakano Ronit Agid Paula Klurfan Marlise Peruzzo dos Santos Souza Derek Armstrong Karel G terBrugge |
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| Institution: | (1) Division of Neuroradiology, Department of Medical Imaging, University Health Network, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada;(2) Toronto Hospital for Sick Children, Toronto, ON, Canada;(3) Present address: Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, 5200, Kihara, Kiyotake, Miyazaki 889-1692, Japan |
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| Abstract: | Case report We report two neonatal patients with high-flow intracranial or cervical arteriovenous (AV) shunts who presented with congestive heart failure and were successfully managed with endovascular treatment. One with vein of Galen malformation with body weight of only 2.0 kg is, to our knowledge, the smallest neonate successfully treated with endovascular treatment. The other neonate is, to our knowledge, the first vertebro-vertebral fistula patient presenting with heart failure and treated successfully with endovascular treatment.Conclusion Even in neonates, endovascular treatment is the procedure of choice for high-flow AV shunts presenting with progressive congestive heart failure resistant to medical management. We discuss limitations and technical considerations of endovascular treatments in small neonates with high-flow AV shunts and congestive heart failure. |
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| Keywords: | Arteriovenous shunt Congestive heart failure Endovascular treatment Neonate Vein of Galen malformation Vertebro-vertebral fistula |
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