Intravascular embolization versus surgical resection for patients with scalp arteriovenous fistula

Jianfeng Zheng,Xiaodong Zhang,Zongduo Guo,Xiaochuan Sun

doi:10.1186/s41016-018-0148-1

Abstract

BackgroundScalp arteriovenous fistula (sAVF) is a rare vascular disease; so far, the standard guidelines for the treatment of sAVF are still unclear. Since its complex vascular anatomical structure, surgical management of sAVF remains an enormous challenge.MethodsBetween March 2016 and October 2017, three patients with sAVF admitted to the First Affiliated Hospital of Chongqing Medical University were reviewed, and clinical characteristics, imaging features, and surgical outcomes were analyzed.ResultsThree consecutive patients with sAVF were admitted to our hospital during the study period. Two patients received intravascular embolization and one patient received surgical resection. No procedure-related complications occurred after successfully treatment. During the long-term follow-up period, three patients recovered well and had no recurrence of lesion.ConclusionsEither intravascular embolization or surgical resection is an effective therapy method for sAVF. Careful identification of angioarchitecture features contributes to successful treatment for the complex sAVF; therefore, it is recommended that neurosurgeons make the best treatment plan based on the location and number of the fistulas, feeding the artery, and draining the vein.

Highlights

Scalp arteriovenous fistula is a rare vascular disease; so far, the standard guidelines for the treatment of sAVF are still unclear
Between March 2016 and October 2017, three consecutive patients with sAVF were admitted to our hospital
Cerebral angiography was performed before operation to identify feeding arteries and draining vein

Summary

Introduction

Scalp arteriovenous fistula (sAVF) is a rare vascular disease; so far, the standard guidelines for the treatment of sAVF are still unclear. Since its complex vascular anatomical structure, surgical management of sAVF remains an enormous challenge. Scalp arteriovenous fistula (sAVF) is defined as an abnormal connection without a capillary vessel between the high-flow feeding artery and the low-flow draining veins of the scalp [1,2,3,4,5,6]. Cerebral angiography is the diagnostic gold standard and can show location and number of the fistulas, expanded feeding arteries, as well as obviously tortuous draining vein. Operation is the main way of treatment for this rare vascular disease, including open surgical resection and intravascu-

Methods

Results

Conclusion