Endovascular Treatment for Pediatric Intracranial and Spinal Arteriovenous Shunt Disease

Abstract

  Precise assessment of the angioarchitecture of cerebrovascular diseases is important for accurate diagnosis and planning surgical, endovascular, or conservative management to minimize the risk of treatment complications. Recent advancements in angiography techniques have enabled the acquisition of high-quality vascular images, even for small vessels, using rotational angiography and cone-beam CT. It is also possible to precisely assess the relationship between vascular pathology and the surrounding normal vessels or other anatomical structures by developing fusion images with other angiographic images or MRI. For example, before aneurysm treatment, we can preoperatively assess the origin and course of the perforators associated with an aneurysm. For spinal shunt diseases, the shunt point can be precisely identified in relation to the surrounding spinal cord, nerve root, dura, and bony and soft tissue structures. This information is important for accurate diagnosis, understanding of the disease, and treatment planning. Vascular imaging with high-resolution angiography is progressively improving and becoming indispensable for the diagnosis and treatment of cerebrovascular diseases.