Endovascular treatment for intracranial pial arteriovenous fistula with a giant varix: case report

Abstract

Objective: We report a case of intracranial pial arteriovenous fistula (pial AVF) with a giant varix completely obliterated by endovascular treatment.
Case presentation: A 17-year-old man presented with mild left hemiparesis and dizziness. Cerebral angiography revealed an intracranial pial AVF with a giant varix arising from the right middle cerebral artery (MCA). By transarterial approach through the fistula into the varix, detachable coils were placed in the varix and the right MCA just proximal to the fistula. This strategy preserved the normal branches of the right MCA arising about 10 mm proximal to the fistula. We then injected n-butyl cyanoacrylate. The pial AVF was obliterated after applying these procedures.
Conclusion: Endovascular treatment is an effective and valuable alternative treatment for patients with pial AVF when a surgical approach is difficult.