E-066 Neonate high flow fistula embolization with high volume coil

We present a case series of 3 neonates who presented to our facility in high flow cardiac output failure or pulmonary hypertension within three days of life. The first child had a large right temporal pial arterial venous fistula (Fig 1a), and the second and third child had Vein of Galen malformations. Two patients had high flow cardiac output failure and one patient had pulmonary hypertension attributable to the intracranial fistula. Each patient was treated with high volume coils (0.020) with specific large vessel sacrifice using a Penumbra Occlusion Device (Fig 1b). We found that large volume coils offer safe reduction in flow, with the ability to control the embolization. These coils can also be used to provide a scaffold for EVOH or nBCA to complete flow arrest in individual vessels. During the procedure, two of the children had a reduction in required vasoactive agents and an improvement in oxygen saturation. The third child had an improvement in oxygen requirements and a reduction in B-type Natriuretic Peptide following embolization. This case suggests a novel, effective method for vessel sacrifice for high flow fistulas in neonates and reduces the cardiopulmonary effects of the fistula in the neonatal period. Abstract E-066 Figure 1 Disclosures B. Bohnstedt: 1; C; Penumbra, Codman, Stryker. V. Pandav: None. S. Dandapat: None. A. Williams: None.
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Electronic Poster Abstracts Source Type: research