Fitness-for-Service Assessment and Re-rating of Flawed Alumina Feeding Vessels

2018 ◽  
pp. 49-55
Author(s):  
Maher Al-Dojayli ◽  
Kyle Chomyn ◽  
Hamid Ghorbani ◽  
Patrice Barriault
Keyword(s):  
Feeding Vessels

scholarly journals Techniques of Onyx Embolization of Arteriovenous Malformation: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Kathryn M Wagner ◽  
Visish M Srinivasan ◽  
Peter Kan
Keyword(s):  
Informed Consent ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Preoperative Embolization ◽  
Great Care ◽  
Endovascular Techniques ◽  
Definitive Therapy ◽  
Feeding Vessels ◽  
Multiple Feeding ◽  
Staged Treatment

Abstract Advances in endovascular techniques and tools have allowed for treatment of complex arteriovenous malformations (AVMs), which historically may have posed unacceptable risk for open surgical resection. Endovascular treatment may be employed as an adjunct to surgical resection or as definitive therapy. Improvements in embolization materials have made endovascular AVM treatment safer for patients and useful across a variety of lesions. While many techniques are employed for transarterial AVM embolization, the essential tenets apply to all procedures: (1) great care should be taken to cannulate only vessels directly supplying the lesion, and not en passage vessels, prior to injecting embolisate; (2) embolisate should travel into the nidus, but not into the draining veins; (3) embolistate reflux proximal to the microcatheter should be avoided. There are several techniques that accomplish these goals, including the plug and push method, or using a balloon to prevent embolisate reflux. We use controlled injection of liquid Onyx (Medtronic), with increasing pressure over multiple injections pushing the embolisate forward into the AVM. This is repeated in multiple feeding vessels to decrease or eliminate supply to the AVM. Here, we present a 36-yr-old female with a right parietal AVM discovered on workup of headaches. After informed consent was obtained, she underwent preoperative embolization using this technique prior to uncomplicated surgical resection. The video shows the endovascular Onyx embolization of multiple feeding vessels over staged treatment.

Cone-Beam CT Angiography for Determination of Tumor-Feeding Vessels During Chemoembolization of Liver Tumors: Comparison of Conventional and Dedicated-Software Analysis

2016 ◽  
Vol 27 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Maxime Ronot ◽  
Mohamed Abdel-Rehim ◽  
Antoine Hakimé ◽  
Viseth Kuoch ◽  
Marion Roux ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Liver Tumors ◽  
Cone Beam Ct ◽  
Cone Beam ◽  
Software Analysis ◽  
Feeding Vessels

scholarly journals Preoperative silk suture embolization of cerebral and dural arteriovenous malformations

2001 ◽  
Vol 11 (5) ◽  
pp. 1-6 ◽  
Author(s):  
Amir R. Dehdashti ◽  
Michel Muster ◽  
Alain Reverdin ◽  
Nicolas De Tribolet ◽  
Daniel A. Ruefenacht
Keyword(s):  
Arteriovenous Malformations ◽  
Histopathological Examination ◽  
Adverse Outcomes ◽  
Neurological Deficits ◽  
Grading System ◽  
Silk Suture ◽  
Long Term Follow Up ◽  
Feeding Vessels ◽  
A Minor ◽  
Proximal Occlusion

Object The aim of this study was to evaluate the use of silk sutures as a medical implant when applied for the embolization of cerebral and dural arteriovenous malformations (AVMs). The facility of surgery and the clinical significance of complications related to preoperative silk suture embolization were evaluated immediately after surgery and at long-term follow up. Methods Thirty-four patients harboring 29 cerebral and five dural AVMs underwent embolization in which silk alone or in association with other agents was used. Medical and radiological records obtained in these 34 patients were reviewed retrospectively. The cerebral AVMs were classified according to the Spetzler–Martin grading system and the dural AVMs to the Djindjian grading system. The facility of the resection and the adverse outcomes, including new neurological deficits, hemorrhage, and fever, as well as histopathological evidence of vessel inflammatory changes, were determined in each case. In all 23 surgical cases, the AVM could be easily manipulated and excised. New temporary neurological deficits occurred in three patients. A high Spetzler–Martin grade was not associated with a higher incidence of new neurological deficits. One delayed-onset hemorrhage was detected after embolization. Fever was present in 24% of the patients. No sign of significant vasculitis or perivascular inflammation was found on radiological or histopathological examination. Conclusions Silk sutures are safe embolic agents especially for proximal occlusion of AVM feeding vessels. New permanent neurological deficits were not encountered in this series. Fever was considered to be a minor, temporary side effect of silk suture embolization.

scholarly journals Surgery Combined With Embolization in the Treatment of Plexiform Neurofibroma: A Case Report and Literature Review

2021 ◽  
Vol 6 (4) ◽  
pp. 01-04
Author(s):  
Reinaldo Filho
Keyword(s):  
Plexiform Neurofibroma ◽  
Arterial Embolization ◽  
Neurofibromatosis Type ◽  
Self Esteem ◽  
Life Threatening ◽  
Feeding Vessels ◽  
The Right ◽  
Polyvinyl Alcohol Particles

Neurofibromatosis type 1 (NF1) is an autosomal dominant multisystem genodermatosis resulting from a mutation on chromosome 17q11.2, characterized by diverse clinical expression with involvement of the skin, nervous system, bones, eyes and other systems. Neurofibromas are tumors located along nerve bundles; when they become large, they are called plexiform neurofibromas. Complications of neurofibromas are rare, but include malignant transformation and potentially life-threatening hemorrhages. A comprehensive perioperative management, including arterial embolization of feeding vessels, is required in order to perform a safe surgical procedure and to reduce potential surgical complications. We report a case of a large plexiform neurofibroma on the right flank, treated in a two-stage approach: first, embolization with polyvinyl alcohol particles of the inferior epigastric, lumbar and superior gluteal arteries on the right and, second, 24 hours after embolization, exeresis of the lesion, which weighed 2.5 kg. Two years after surgery, the patient was asymptomatic, without tumor recurrence and with an important improvement in self-esteem and quality of life.

Giant arteriovenous fistula of the vein of Galen in early infancy treated successfully with surgery

1980 ◽  
Vol 53 (5) ◽  
pp. 703-706 ◽  
Author(s):  
Jose Andres Alvarez-Garijo ◽  
Manuel Vila Mengual ◽  
Dario Taboada Gomila ◽  
Adela Alonso Martin
Keyword(s):  
Heart Failure ◽  
Arteriovenous Fistula ◽  
Vein Of Galen ◽  
Cerebral Damage ◽  
Left Hemiparesis ◽  
Content Type ◽  
Feeding Vessels ◽  
Unusual Lesion ◽  
Persistent Hydrocephalus ◽  
Fine Print

✓ A giant arteriovenous fistula in a newborn infant was treated by surgical occlusion of the feeding vessels at 20 days of life. Congestive heart failure responded favorably to operative treatment. Because of persistent hydrocephalus, a shunt was inserted at 2 months of age. At 9 months of age, the child remained without signs of cardiac failure. Cerebral damage was manifested by a mild left hemiparesis. Successful surgical treatment of this unusual lesion in a neonate is exceptional.

Prenatal Percutaneous Fetoscopic Laser Photocoagulation of Chorioangioma: Report of Two Cases and Review of the Literature

2021 ◽  
pp. 1-7
Author(s):  
Hanane Bouchghoul ◽  
Alexandra Benachi ◽  
Marie-Victoire Senat
Keyword(s):  
Blood Flow ◽  
Laser Photocoagulation ◽  
Therapeutic Option ◽  
Intraoperative Ultrasound ◽  
Peak Systolic Velocity ◽  
Doppler Flow ◽  
Complete Cessation ◽  
Feeding Vessels ◽  
Doppler Indices ◽  
The Right

<b><i>Introduction:</i></b> In Doppler flow diagnosis of a large placental chorioangioma with vascularization, there may be fetal consequences as cardiac output failure and polyhydramnios. Prenatal percutaneous fetoscopic laser photocoagulation of chorioangioma is a therapeutic option. First, we present 2 cases of chorioangioma treated by fetoscopic laser photocoagulation. Second, we conducted a narrative review to identify all reported cases of chorioangioma treated by fetoscopic laser photocoagulation. <b><i>Case Presentation:</i></b> Case 1 presented a chorioangioma measuring 48 × 36 × 42 mm, and the Doppler flow study showed vascularization with a high flow rate. The fetus showed dilatation of the right cardiac chambers, moderate tricuspid insufficiency, normal Doppler indices, and polyhydramnios. Case 2 presented a chorioangioma measuring 58 × 36 × 31 mm associated with polyhydramnios and elevated peak systolic velocity of the middle cerebral artery at 49 cm/s, that is, 1.65 MoM. The procedure was performed at 22<sup>+2</sup> and 23<sup>+5</sup> WG for both cases. Photocoagulation of the chorioangioma vessels was performed first on the small superficial vessels (capillaries) and then on the feeding vessels (artery first and then vein), until complete cessation of blood flow on ultrasound. Successful devascularization was achieved when flow within the chorioangioma’s feeding vessels was no longer visualized on intraoperative ultrasound examination using Doppler flow. The ultrasound follow-up showed complete cessation of blood flow in the chorioangioma, normalization of fetal signs, and normal fetal growth in both cases. In case 1, a 2,350-g boy was delivered vaginally after spontaneous labor at 33<sup>+6</sup> WG. In case 2, a 2,700-g boy was delivered vaginally after spontaneous labor at 39<sup>+2</sup> WG. Neonatal findings were normal, and the outcome at 1 year was normal for both children. <b><i>Conclusion:</i></b> Prenatal percutaneous fetoscopic laser photocoagulation improves survival in large chorioangioma, despite a risk of fetal death in utero.

scholarly journals Chorioangioma: A Case Report

2020 ◽  
Author(s):  
Veena Panat
Keyword(s):  
Case Report ◽  
Insertion Site ◽  
Benign Tumors ◽  
Laser Coagulation ◽  
Fetal Anemia ◽  
Patient Counseling ◽  
Maternal Complications ◽  
Expectant Mothers ◽  
Feeding Vessels ◽  
Fetal Wellbeing

Abstract Chorioangiomas are benign tumors of the placenta, characterised by AV shunting within placenta leading to fetal anemia, cardiomegaly and hydrops. Maternal complications are also known as polyhydramnios, APH and Mirror syndrome. They are seen after 20 weeks, and most of them remain small and are asymptomatic. Large ones (> 4 cm) can create complications for the fetus and expectant mothers. The proximity of the chorioangioma to the placental cord insertion site and its size determines prognosis. Prenatal therapy in the form of interventions like direct injections of various chemicals and laser coagulation of the tumor’s feeding vessels are described in the literature. Conservative management may also be offered in certain circumstances. We report a case of large Chorioangioma managed conservatively. Early diagnosis was made, patient counseling followed by close surveillance with Doppler, MCA PSV was done for fetal wellbeing. The timely intervention led to good neonatal and maternal outcome aided with NICU management.

scholarly journals Blockage of uterine-feeding vessels—A real choice to maintain the uterus?

2011 ◽  
Vol 74 (7) ◽  
pp. 285-286 ◽  
Author(s):  
Kuan-Hao Tsui ◽  
Peng-Hui Wang
Keyword(s):  
Feeding Vessels

Synthesis and experimental study of a dextran-ferrite-based magnetically driven nanopreparation as an MRI contrast agent for tumor-feeding vessels

2011 ◽  
Vol 45 (2) ◽  
pp. 84-87
Author(s):  
N. A. Brusentsov ◽  
Yu. A. Pirogov ◽  
A. A. Uchevatkin ◽  
V. A. Polyanskii ◽  
T. N. Brusentsova ◽  
...  
Keyword(s):  
Experimental Study ◽  
Contrast Agent ◽  
Mri Contrast Agent ◽  
Mri Contrast ◽  
Feeding Vessels

Gastric metastasis presenting as an overt upper gastrointestinal bleeding treated with chemoembolisation in a patient diagnosed with papillary thyroid carcinoma

2020 ◽  
Vol 13 (9) ◽  
pp. e237022
Author(s):  
Lester Jan Alvarado Olimba ◽  
Ruter Magtibay Maralit ◽  
Davidson Viar Pastrana ◽  
Jose Louie Dela Cerna Remotigue
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Gastrointestinal Bleeding ◽  
Upper Gastrointestinal Bleeding ◽  
Papillary Thyroid ◽  
Standard Medical Therapy ◽  
Gastric Mass ◽  
Feeding Vessels ◽  
Histopathological Studies ◽  
Upper Gastrointestinal

We present a case of a patient with known papillary thyroid carcinoma presenting with overt upper gastrointestinal bleeding from a metastatic gastric mass. The gastric mass was diagnosed through transnasal endoscopy with tissue biopsies, revealing papillary thyroid carcinoma cells on histopathological studies. Bleeding was persistent despite standard medical therapy. Chemoembolisation of the major feeding vessels of such tumour provided resolution of bleeding.

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