单中心治愈性栓塞儿童脑动静脉畸形的血管构筑特征分析OA北大核心CSCDCSTPCD

Objective This study aims to summarize the vascular features associated with the curative endovascular embolization treatment of pediatric cerebral arteriovenous malformations(cAVM)in a single-cen-ter setting.Methods A retrospective collection of clinical data from 36 pediatric cAVM patients who underwent curative embolization treatment at the Department of Neurosurgery,Children's Hospital of Chongqing Medical Uni-versity,between September 2018 and August 2023 was performed.These were compared with clinical data from 81 non-curative embolization cases treated during the same period.The clinical manifestations,imaging characteris-tics,vascular features,and surgical data of the curative embolization group were analyzed.Results Among the 36 pediatric cAVM patients who underwent curative embolization,26 were male and 10 were female.The age of onset ranged from 4 months to 15 years.The AVM nidus was primarily located supratentorial(28/36,77.8％),small-sized(23/36,63.9％),superficial(23/36,63.9％),and in non-functional areas(27/36,75.0％).The feeding arteries were mostly superficial arteries(29/36,80.5％),single-feed(27/36,75.0％),and showed no signs of dilation or stenotic structural abnormalities(28/36,77.8％).Venous drainage was predominantly super-ficial veins(26/36,72.2％),single-drainage(31/36,86.1％),and no dilation or stenotic structural abnormali-ties(30/36,83.3％).The Spetzler-Martin(SM)grades were Ⅰ in 18 cases,Ⅱ in 14 cases,and Ⅲ in 4 cases.Two patients(2/36,5.6％)experienced hemorrhagic complications,and one patient(1/36,2.8％)had ischemic complications.At discharge,the modified Rankin scale(mRS)scores were 0-2 in 34 cases(34/36,94.4％),and ≥3 in 2 cases(2/36,5.6％).The average follow-up duration was 35.5 months,and at the final follow-up,35 patients(35/36,97.2％)had an mRS score of 0-2,while 1 patient(1/36,2.8％)had an mRS score of ≥3.A significant difference was observed between the curative and non-curative embolization groups regarding the size of the cAVM(x2=7.571,P=0.014)and the depth of the lesion(x2=4.263,P=0.039).However,no significant difference was found in the location of the lesion(supratentorial vs.infratentorial)(x2=0.183,P=0.668)or functional vs.non-functional areas(x2=0.145,P=0.704).Conclusions Curative embolization treatment yields favorable outcomes for pediatric cAVM patients.Children with lower SM grades and simpler vascular struc-tures are more likely to achieve successful curative embolization.