scholarly journals Complications of Endovascular Treatment of Intracranial Dural Arteriovenous Fistulas

2021 ◽  
pp. 123-127
Author(s):  
Naoya Kuwayama ◽  
Naoki Akioka
Keyword(s):  
Endovascular Treatment ◽  
Open Surgery ◽  
Nerve Palsy ◽  
Stereotactic Radiation ◽  
Arteriovenous Fistulas ◽  
Major Complications ◽  
Material Migration ◽  
Before And After ◽  
Arterial Anastomosis ◽  
Av Fistulas

AbstractAims: To report the endovascular treatment and complications of intracranial and spinal dural arteriovenous (AV) fistulas. Methods: A retrospective analysis of 863 cases with dural AV fistulas was completed in the nationwide registry study of the Japanese Society of Neuroendovascular Therapy. Results: Treatments included transarterial/transvenous embolization (TAE/TVE), open surgery, stereotactic radiation, and their combinations. Modified Rankin Scale 0 (mRS-0) of the patients before and after treatment were 21% and 68%, and mRS 0-1were 69% and 86%, respectively. Mortality rate after treatment was 0.6%. Major complications of TAE and TVE were cranial nerve palsy and cerebral infarction. Conclusions: Major complications resulted from occlusion of vasa nervosum and material migration via dangerous intracranial and extracranial arterial anastomosis.

Pitfalls in Endovascular Treatment of Dural Arteriovenous Fistulas Involving the Cavernous Sinus

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 88-92
Author(s):  
N. Kuwayama ◽  
S. Endo ◽  
M. Kubo ◽  
T. Akai ◽  
A. Takaku
Keyword(s):  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Transarterial Embolization ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Arteriovenous Fistulas ◽  
Type D ◽  
Dural Arteriovenous Fistulas ◽  
The Right

Angiographic changes of the sylvian veins, superior ophthalmic vein (SOV), and superior petrosal sinus (SPS) before and after endovascular treatment were determined for 18 patients with dural arteriovenous fistulas (AVFs) involving the cavernous sinus, and pitfalls of endovascular treatment, especially regarding venous drainage routes, for 3 of the patients were reported. Case 1: 57-year-old woman who presented with right abducens nerve palsy had a Barrow type D fistula in the right cavernous sinus draining into the bilateral inferior petrosal sinuses (IPS). One of the ipsilateral sylvian veins that had drained antegradely before treatment was occluded, and a small lacunar infarction in the corona radiata developed after transvenous embolization (TVE) of the right cavernous sinus. Case 2: 72-year-old woman who presented with symptoms of right ocular hypertension had a type D fistula in the right cavernous sinus draining into only the ipsilateral SOV. Conjunctival hyperemia persisted and was aggravated after angioanatomical obliteration of the fistula by transarterial embolization. Case 3: 55-year-old man who presented with left abducens nerve palsy had a type D fistula in the left cavernous sinus draining into the ipsilateral IPS and sylvian vein. The dural AVF was obliterated once with TVE, but recurred 1 week later with retrograde drainage into the ipsilateral SPS and mesencephalic veins. A second TVE resulted in complete obliteration of the fistula. In conclusion, detailed analysis of drainage routes is necessary for planning of treatment of patients with dural AVF, and prompt treatment is needed when redistribution of drainage routes develops during or after TVE.

Endovascular treatment of intracranial dural arteriovenous fistulas with spinal perimedullary venous drainage

1992 ◽  
Vol 77 (5) ◽  
pp. 718-723 ◽  
Author(s):  
Y. Pierre Gobin ◽  
Andre Rogopoulos ◽  
Armand Aymard ◽  
Mazen Khayata ◽  
Daniel Reizine ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Endovascular Therapy ◽  
Sinus Thrombosis ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Venous Hypertension ◽  
Arterial Phase ◽  
Content Type ◽  
Arteriovenous Fistulas ◽  
Av Fistulas

✓ Intracranial dural arteriovenous (AV) fistulas with spinal perimedullary venous drainage are rare lesions that have distinctive clinical, radiological, and therapeutic aspects. Five patients presented with an ascending myelopathy, which extended to involve the brain stem in three cases. Myelography and magnetic resonance imaging showed slightly dilated spinal perimedullary vessels. Spinal angiograms were normal in the arterial phase. Diagnosis was only possible after cerebral angiography, which demonstrated posterior fossa AV fistulas fed by meningeal arteries and draining into spinal perimedullary veins. Endovascular treatment alone resulted in angiographic obliteration of the lesion in three patients. Two patients required surgery in addition to endovascular therapy. One patient died postoperatively, and in one a transient complication of embolization was observed. Improvement after treatment was good in two cases and fair in two. Transverse sinus thrombosis was observed in three cases and was probably the cause of the aberrant venous drainage of the fistula into the spinal perimedullary veins. The pathophysiology is related to spinal cord venous hypertension. These lesions were classified as Type 5 in the Djindjian and Merland classification of dural intracranial AV fistulas. Endovascular therapy is a safe effective method in the treatment of these fistulas and should be tried first.

Evaluation of dural arteriovenous fistulas of cavernous sinus before and after endovascular treatment using time-resolved MR angiography

2010 ◽  
Vol 33 (2) ◽  
pp. 217-223 ◽  
Author(s):  
Shigeyuki Sakamoto ◽  
Masaaki Shibukawa ◽  
Yoshihiro Kiura ◽  
Toshinori Matsushige ◽  
Nobukazu Abe ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Mr Angiography ◽  
Time Resolved ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Before And After

scholarly journals Oral Charcoal Adsorbents Attenuate Neointima Formation of Arteriovenous Fistulas

Toxins ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 237 ◽  
Author(s):  
Yu-Chung Shih ◽  
Chih-Cheng Wu ◽  
Shen-Chih Wang ◽  
Jun-Yang Liou ◽  
Po-Hsun Huang ◽  
...  
Keyword(s):  
External Jugular Vein ◽  
Uremic Toxins ◽  
Uremic Toxin ◽  
Neointima Formation ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Toxin Binding ◽  
Before And After ◽  
Av Fistulas

Chronic kidney disease (CKD) accelerates the development of neointima formation at the anastomosis site of arteriovenous (AV) fistulas. Accumulation of certain uremic toxins has a deleterious effect on the cardiovascular system. The oral charcoal adsorbent, AST-120, reduces circulating and tissue uremic toxins, but its effect on neointima formation at an AV fistula is unknown. To understand the effect of CKD and AST-120 on neointima formation, we created AV fistulas (common carotid artery to the external jugular vein in an end-to-side anastomosis) in mice with and without CKD. AST-120 was administered in chow before and after AV fistula creation. Administration of AST-120 significantly decreased serum indoxyl sulfate levels in CKD mice. CKD mice had a larger neointima area than non-CKD mice, and administration of AST-120 in CKD mice attenuated neointima formation. Both smooth muscle cell and fibrin components were increased in CKD mice, and AST-120 decreased both. RNA expression of MMP-2, MMP-9, TNFα, and TGFβ was increased in neointima tissue of CKD mice, and AST-120 administration neutralized the expression. Our results provided in vivo evidence to support the role of uremic toxin-binding therapy on the prevention of neointima formation. Peri-operative AST-120 administration deserves further investigation as a potential therapy to improve AV fistula patency.

scholarly journals Endovascular Treatment for Tentorial Dural Arteriovenous Fistulas

2010 ◽  
Vol 38 (4) ◽  
pp. 235-242 ◽  
Author(s):  
Naoko MIYAMOTO ◽  
Isao NAITO ◽  
Shin TAKATAMA ◽  
Tomoyuki IWAI ◽  
Masahiro MATSUMOTO ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

Open and Endovascular Treatment of Unruptured Carotid-Ophthalmic Aneurysms: Clinical and Radiographic Outcomes

Neurosurgery ◽  
2011 ◽  
Vol 68 (5) ◽  
pp. 1434-1443 ◽  
Author(s):  
Sanjay Yadla ◽  
Peter G. Campbell ◽  
Bartosz Grobelny ◽  
Jack Jallo ◽  
L. Fernando Gonzalez ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Combined Treatment ◽  
Combined Modality Treatment ◽  
Endovascular Techniques ◽  
Patient Demographics ◽  
Radiographic Outcomes ◽  
Major Complications ◽  
Initial Procedure ◽  
Elective Setting

Abstract BACKGROUND: Aneurysms of the carotid-ophthalmic artery present unique challenges to cerebrovascular neurosurgeons given their proximity to vital anatomic structures. OBJECTIVE: To report our experience with a combined-modality treatment of unruptured carotid-ophthalmic aneurysms over a 12-year period. METHODS: A retrospective review of 161 patients who underwent open, endovascular, or combined treatment of 170 aneurysms from January 1997 to July 2009 was conducted. Medical records, operative reports, office notes, and follow-up angiograms were reviewed to obtain data on patient demographics, angiographic results, and clinical outcomes. RESULTS: One hundred forty-seven aneurysms were treated via endovascular techniques; 17 aneurysms (10%) were treated with microsurgical clip ligation; and 6 aneurysms (3.5%) were treated with a combined approach. Of the aneurysms treated via an endovascular approach alone, 81.6% of aneurysms had evidence of ≥ 95% occlusion on initial angiogram. There was a 1.4% rate of major complications associated with the initial procedure. Twenty-six of these aneurysms (18.9%) required further intervention on the basis of early angiographic results. Major complications occurred after 6 of 23 open microsurgical procedures (26.1%), including 2 instances of permanent visual loss. Nine clipped patients had long-term angiographic follow-up; none required further intervention. CONCLUSION: Endovascular treatment of carotid-ophthalmic aneurysms with modern endovascular techniques can be performed safely and efficaciously in the elective setting.

Percutaneous transvenous embolization of a dural arteriovenous fistula through a mastoid emissary vein

2006 ◽  
Vol 105 (4) ◽  
pp. 636-639 ◽  
Author(s):  
Dennis J. Rivet ◽  
James K. Goddard ◽  
Keith M. Rich ◽  
Colin P. Derdeyn
Keyword(s):  
Endovascular Treatment ◽  
Transverse Sinus ◽  
Dural Sinus ◽  
Type Ii ◽  
Emissary Vein ◽  
Arteriovenous Fistulas ◽  
Mastoid Emissary Vein ◽  
Vein Access ◽  
Dural Arteriovenous Fistulas ◽  
Gain Access

✓ Definitive endovascular treatment of dural arteriovenous fistulas (DAVFs) requires obliteration of the site of the fistula: either the diseased dural sinus or the pial vein. Access to this site is often limited by occlusion of the sinus proximal and distal to the segment containing the fistula. The authors describe a technique in which the mastoid emissary vein is used to gain access to a Borden–Shucart Type II DAVF in the transverse–sigmoid sinus. Recognition of this route of access, if present, may facilitate endovascular treatment of these lesions. Access to the transverse sinus via this approach can be straightforward and may be underused.

Percutaneous Superselective Coil-Embolization of Intrarenal Arteriovenous Fistulas

1996 ◽  
Vol 37 (3P2) ◽  
pp. 539-541 ◽  
Author(s):  
H. Husstedt ◽  
A. Chavan ◽  
F. Ghadban ◽  
A. Leppert ◽  
M. Galanski
Keyword(s):  
Coil Embolization ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Percutaneous Catheter ◽  
Coil Occlusion ◽  
Av Fistulas ◽  
Small Parts

Purpose: To evaluate the role of percutaneous transcatheter coil-occlusion in the management of uncontrollable postoperative hematuria due to iatrogenic arteriovenous (AV) fistula. Material and Methods: In 2 patients, AV fistulas were occluded with percutaneous catheter-guided superselective coil embolization. Results: In both cases, occlusion of the AV fistulas was successful. Only small parts (less than 10%) of the parenchyma had to be sacrificed. No hypertension occurred. Conclusion: Percutaneous coil embolization is a useful alternative to surgery in cases of postoperative AV fistulas. Hematuria can be effectively controlled without resulting hypertension.

scholarly journals Alterations of blood flow pattern after triple stent endovascular treatment of saccular abdominal aortic aneurysm: a porcine model.

2016 ◽  
Vol 43 (3) ◽  
pp. 154-159
Author(s):  
JAHIR RICHARD DE OLIVEIRA ◽  
MAURÍCIO DE AMORIM AQUINO ◽  
SVETLANA BARROS ◽  
GUILHERME BENJAMIN BRANDÃO PITTA ◽  
ADAMASTOR HUMBERTO PEREIRA
Keyword(s):  
Blood Flow ◽  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Endovascular Treatment ◽  
Flow Pattern ◽  
Blood Flow Pattern ◽  
Large White ◽  
Abdominal Aortic ◽  
Before And After ◽  
Infrarenal Abdominal Aorta

ABSTRACT Objective: to determine the blood flow pattern changes after endovascular treatment of saccular abdominal aortic aneurysm with triple stent. Methods: we conducted a hemodynamic study of seven Landrace and Large White pigs with saccular aneurysms of the infrarenal abdominal aorta artificially produced according to the technique described. The animals were subjected to triple stenting for endovascular aneurysm. We evaluated the pattern of blood flow by duplex scan before and after stent implantation. We used the non-paired Mann-Whitney test for statistical analysis. Results: there was a significant decrease in the average systolic velocity, from 127.4cm/s in the pre-stent period to 69.81cm/s in the post-stent phase. There was also change in the flow pattern from turbulent in the aneurysmal sac to laminate intra-stent. Conclusion: there were changes in the blood flow pattern of saccular abdominal aortic aneurysm after endovascular treatment with triple stent.

scholarly journals Pulse-Spray Pharmacomechanical Thrombolysis of Native Arteriovenous Fistulas and Grafts under Ultrasound Guidance: Our Initial Experience

2017 ◽  
Vol 01 (01) ◽  
pp. 020-022
Author(s):  
Praveen Vasanthraj ◽  
Varun Bandi ◽  
Venkata Sai ◽  
Manikanthan Shekar
Keyword(s):  
Ultrasound Guidance ◽  
Renal Diseases ◽  
Initial Experience ◽  
Ultrasound Guided ◽  
Arteriovenous Fistulas ◽  
Catheter Directed Thrombolysis ◽  
Trained Personnel ◽  
Av Fistulas ◽  
Care Procedure ◽  
Chronic Renal Diseases

AbstractChronic renal diseases have been on rise with most patients requiring renal transplantation. With advances in treatment, patients undergo hemodialysis through arteriovenous (AV) fistulas and grafts. Thrombosis in these fistulas and grafts are more common and may result in failure. Interventional radiology plays an important role in managing these thromboses through catheter-directed thrombolysis. With success rate of more than 80%, catheter-directed thrombolysis has become the treatment of choice. However, the need of trained personnel, well-equipped catheter laboratories, and expensiveness are its disadvantages. We share our initial experience in two patients in whom we have performed ultrasound-guided percutaneous pulse-spray pharmacomechanical thrombolysis as a day-care procedure. This technique is less expensive, can have a wider outreach, and patients can be benefitted early to avoid new access.

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