Minh Ngoc Thien Kim Tran Dong's scientific contributions

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Publications (1)


Embolization of cerebral arteriovenous shunts in infants weighing less than 5 kg
  • Article

February 2019

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51 Reads

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10 Citations

Journal of Neurosurgery Pediatrics

Francesco Puccinelli

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Minh Ngoc Thien Kim Tran Dong

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OBJECTIVE Endovascular treatment in children, especially neonates, can be more challenging than analogous procedures in adults. This study aimed to describe the clinical and radiological findings, type and timing of endovascular treatment, and early outcomes in children who present with neurovascular malformations, who are treated with embolization, and who weigh less than 5 kg.METHODS The authors carried out a retrospective review of all consecutively treated children weighing less than 5 kg with neurovascular arteriovenous malformations (AVMs) at a single institution over a 10-year period.RESULTSFifty-two patients were included in the study. Thirty-eight had a vein of Galen aneurysmal malformation, 3 a pial AVM, 6 a pial arteriovenous fistula, and 5 a dural sinus malformation. The endovascular treatment goals were control of cardiac failure or hydrocephalus in cases of nonhemorrhagic malformations or to prevent new bleeding in cases of previous hemorrhage. A hemorrhagic complication occurred in 12 procedures and an ischemic complication in 2. Both complication types were correlated with the age of the infant (age cutoff at 3 months) (p = of 0.015 and 0.049, respectively). No correlation was found with the weight of the infant or the duration of the procedure.CONCLUSIONS The embolization of AVMs in these patients prevented adverse cardiac effects, hydrovenous disorders, and rebleeding. The risk of major cerebral complications seems mainly correlated with age, with a threshold at 3 months. A multidisciplinary team involved in the treatment of these children may help to improve treatment success and management.

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Citations (1)


... Embolization by endovascular treatment has become the standard treatment for cerebral arteriovenous shunts, in particular for VGAM [2]. When possible, the procedure should be postponed after 3 months of age, considering the worse outcomes reported in infants weighing less than 5 kg, including adverse cardiac effects and major cerebral complications due to rebleeding [6]. However, high-output cardiac heart failure is the most common presentation of intracranial AVSs in the neonatal period (Fig. 3) [2], with features overlapping to those of congenital heart disorders that characterize the clinical picture: cyanosis, compromised peripheral pulses, and a cardiac murmur (often audible also through the fontanelle) [7,8]. ...

Reference:

Use of levosimendan in hemodynamic management of heart failure in two neonates with intracranial arteriovenous shunts: a case series
Embolization of cerebral arteriovenous shunts in infants weighing less than 5 kg
  • Citing Article
  • February 2019

Journal of Neurosurgery Pediatrics