AI Article Synopsis
- Cerebral venous thrombosis can occur after the surgical or endovascular treatment of arteriovenous fistulas (AVFs), a rare but serious complication.
- Two cases of patients with AVFs showed rapid neurological decline after surgery, leading to significant complications: one died and the other was left severely disabled.
- Effective management of high-flow AVFs may require strict anticoagulation therapy to prevent thrombosis, though this can be challenging, especially post-surgery due to the risk of bleeding.
Article Abstract
Background: Cerebral venous thrombosis developing after surgical or endovascular obliteration of arteriovenous fistula (AVF) is a rare but devastating complication that has not been adequately reported.
Case Description: Two patients presenting with AVF (1 pial, 1 dural) and large venous pouches were successfully treated by surgical and endovascular means and were neurologically intact postoperatively. Rapid neurologic deterioration was seen on postoperative day 5 in the first patient and postoperative day 2 in the second patient. Both patients had massive cerebral venous thromboses on brain imaging and surgical exploration. One patient died and the other was severely disabled.
Conclusion: Rapid occlusion of a high-flow AVF resulting in significant venous stasis can precipitate thrombosis of the venous system distal to the fistulous point. In the presence of large venous pouches and significant venous stasis, strict therapeutic anticoagulation may be required to prevent cerebral venous thrombosis. Therapeutic anticoagulation, though feasible following endovascular treatment, may prove particularly challenging after open surgical interventions given the risk of hemorrhagic complications.
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| http://dx.doi.org/10.1016/j.wneu.2012.10.043 | DOI Listing |
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