Frontiers in Neurology (Jul 2022)
Case report: Endovascular treatment of two scalp arteriovenous malformation cases via direct percutaneous catheterization: A case series
- Yuan Shi,
- Yuan Shi,
- Yuan Shi,
- Yuan Shi,
- Yuan Shi,
- Peixi Liu,
- Peixi Liu,
- Peixi Liu,
- Peixi Liu,
- Peixi Liu,
- Yingtao Liu,
- Kai Quan,
- Kai Quan,
- Kai Quan,
- Kai Quan,
- Kai Quan,
- Peiliang Li,
- Peiliang Li,
- Peiliang Li,
- Peiliang Li,
- Peiliang Li,
- Zongze Li,
- Zongze Li,
- Zongze Li,
- Zongze Li,
- Zongze Li,
- Wei Zhu,
- Wei Zhu,
- Wei Zhu,
- Wei Zhu,
- Wei Zhu,
- Yanlong Tian,
- Yanlong Tian,
- Yanlong Tian,
- Yanlong Tian,
- Yanlong Tian
Affiliations
- Yuan Shi
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Yuan Shi
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Yuan Shi
- National Center for Neurological Disorders, Shanghai, China
- Yuan Shi
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Yuan Shi
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- Peixi Liu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Peixi Liu
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Peixi Liu
- National Center for Neurological Disorders, Shanghai, China
- Peixi Liu
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Peixi Liu
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- Yingtao Liu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
- Kai Quan
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Kai Quan
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Kai Quan
- National Center for Neurological Disorders, Shanghai, China
- Kai Quan
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Kai Quan
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- Peiliang Li
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Peiliang Li
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Peiliang Li
- National Center for Neurological Disorders, Shanghai, China
- Peiliang Li
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Peiliang Li
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- Zongze Li
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Zongze Li
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Zongze Li
- National Center for Neurological Disorders, Shanghai, China
- Zongze Li
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Zongze Li
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Wei Zhu
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Wei Zhu
- National Center for Neurological Disorders, Shanghai, China
- Wei Zhu
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Wei Zhu
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- Yanlong Tian
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
- Yanlong Tian
- Institute of Neurosurgery, Fudan University, Shanghai, China
- Yanlong Tian
- National Center for Neurological Disorders, Shanghai, China
- Yanlong Tian
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Yanlong Tian
- Shanghai Key Laboratory of Brain Function and Restoration and Neural Regeneration, Shanghai, China
- DOI
- https://doi.org/10.3389/fneur.2022.945961
- Journal volume & issue
-
Vol. 13
Abstract
BackgroundScalp arteriovenous malformations (AVM) are rare vascular malformations reported only in small case series. Scalp AVMs usually present with symptoms, including headache, tinnitus, epilepsy, cerebral ischemia, and necrosis of the scalp, which can cause functional, cosmetic, and psychological problems. There are many difficulties in the treatment of scalp AVM because of its complex characteristics of vascular anatomy, non-uniform structure, and intracranial-extracranial anastomosis.Case descriptionTo illustrate the endovascular treatment of scalp AVM via direct percutaneous puncture while traditional arterial and venous approaches were not available. In this report, access was obtained through a direct puncture of the enlarged frontal vein. Onyx-18 was injected through a microcatheter to occlude draining veins, fistulous connection, and the feeders. An 18-gauge indwelling needle was inserted into draining veins directly. Postembolization angiography demonstrated complete sAVM occlusion immediately and no non-targeted embolization. At a 1-year follow-up, no procedure-related complications and evidence of recurrence were observed.ConclusionThe technique of endovascular embolization via direct percutaneous puncture approach is safe, rapid, and effective for specific sAVM. Treatment options should be made in terms of size, vascular anatomical characteristics of the lesions, patient's preference, cosmetic factors, and available expertise.
Keywords
- scalp arteriovenous malformation
- scalp arteriovenous fistula
- endovascular embolization
- direct percutaneous puncture
- case report
