Cerebral Diagnostic and Therapeutic Angiography for Neonatal Arteriovenous Fistulas

Abstract

<jats:p> Cerebral diagnostic and therapeutic angiography for neonatal arteriovenous fistulas is reported. Three neonatal boys with vein of Galen aneurysmal malformation (1 patient) and dural arteriovenous fistulas (2 patients) presented severe congestive heart failure soon after birth, and were treated by transarterial and/or transvenous embolization using various access routes. In the neonatal period, umbilical approach and direct cervical approach provide unique access routes in addition to the usual transfemoral route. Characteristics of neonatal angiography are discussed. </jats:p>

Neuroimaging in Perinatal Stroke and Cerebrovascular Disease

“…MRI can diagnose hemorrhage, differentiate hemorrhagic transformation of arterial or venous infarction from primary hemorrhages, and is well-suited to evaluation of the brain parenchyma for an underlying mass or large vascular malformation. SWI uses magnitude and phase data to create high-resolution images to visualize intravascular venous deoxygenated blood and blood breakdown products and can help differentiate hemorrhage from calcification (88). The paramagnetic effects of blood products contribute to the heterogeneity of diffusion characteristics.…”

“…Pediatric venous infarcts secondary to CSVT/thrombosis of medullary veins occur most often (more than 40%) in the neonatal period (88,89). The reported incidence of venous thrombosis is 2.6 per 100,000 (1,88,90). Approximately 50-60% percent suffer venous infarction, of which about 75% are hemorrhagic (21).…”

Pediatric Mesenteric Vasculature: Noninvasive Imaging and Catheter Arteriography

“…Very small infants may not be able to undergo femoral angiography due to small vessel size and inability to catheterize vessels; some authors suggest a threshold below 2,500-g birthweight. 25 The standard access site is the common femoral artery, with brachial, radial, and umbilical access sites less commonly utilized. 24,25 The patient's weight should be documented, as medication and contrast doses will be weight-based.…”

“…25 The standard access site is the common femoral artery, with brachial, radial, and umbilical access sites less commonly utilized. 24,25 The patient's weight should be documented, as medication and contrast doses will be weight-based.…”

Coil and Onyx embolization of a torcular herophili dural arteriovenous fistula in a full-term neonate with advanced heart failure using a transumbilical approach

“…20 In low birth weight neonates with DAVFs, flow in the descending aorta may be compromised, further complicating endovascular access. 2,7 In patients with birth weights less than 2700 g, obtaining access through other vessels, such as the umbilical arteries, is an alternative. Accessing the umbilical vessels must be obtained within the first week of life before the vessels obliterate.…”