Anterior choroidal artery embolization in cerebral arteriovenous malformations

1991 ◽  
pp. 548-549 ◽  
Author(s):  
C. F. Dowd ◽  
V. V. Halbach ◽  
S. L. Barnwell ◽  
R. T. Higashida ◽  
G. B. Hieshima
Keyword(s):  
Arteriovenous Malformations ◽  
Anterior Choroidal Artery ◽  
Cerebral Arteriovenous Malformations ◽  
Artery Embolization ◽  
Anterior Choroidal ◽  
Choroidal Artery

Sylvian Fissure Arteriovenous Malformations

Neurosurgery ◽  
1987 ◽  
Vol 21 (1) ◽  
pp. 7-14 ◽  
Author(s):  
Kenichiro Sugita ◽  
Toshiki Takemae ◽  
Shigeaki Kobayashi
Keyword(s):  
Arteriovenous Malformations ◽  
Sylvian Fissure ◽  
Neurological Deficits ◽  
Surgical Results ◽  
Anterior Choroidal Artery ◽  
Points Of View ◽  
Characteristic Features ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Angiographic Findings

Abstract We have operated on 16 cases of arteriovenous malformation (AVM) in and around the sylvian fissure. We call these lesions “sylvian fissure AVMs” and classify them into four subdivisions, namely, pure, lateral, medial, and deep AVMs. By others, they have been variously called AVMs of the basal ganglia, insula, anterior choroidal artery, frontal lobe, or temporal lobe. These sylvian fissure AVMs showed similar angiographic findings: the feeders in all cases were branches of the middle cerebral artery; in some cases, additional feeders from the anterior and posterior choroidal and posterior communicating arteries were present also. We describe the characteristic features of these AVMs from the anatomical and surgical points of view. The surgical results were satisfactory in 15 cases (no additional neurological deficits), and 1 patient died. (Neurosurgery 21: 7-14, 1987)

scholarly journals Embolization of the choroidal artery in the treatment of cerebral arteriovenous malformations

2017 ◽  
Vol 126 (4) ◽  
pp. 1114-1122 ◽  
Author(s):  
Alaa Elkordy ◽  
Hidenori Endo ◽  
Kenichi Sato ◽  
Yasushi Matsumoto ◽  
Ryushi Kondo ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Open Surgery ◽  
Gamma Knife Radiosurgery ◽  
Internal Capsule ◽  
Endovascular Embolization ◽  
Anterior Choroidal Artery ◽  
Cerebral Avms ◽  
Anterior Choroidal ◽  
Choroidal Artery

OBJECTIVE The anterior and posterior choroidal arteries are often recruited to supply arteriovenous malformations (AVMs) involving important paraventricular structures, such as the basal ganglia, internal capsule, optic radiation, lateral geniculate body, and medial temporal lobe. Endovascular embolization through these arteries is theoretically dangerous because they supply eloquent territories, are of small caliber, and lack collaterals. This study aimed to investigate the safety and efficacy of embolization through these arteries. METHODS This study retrospectively reviewed 13 patients with cerebral AVMs who underwent endovascular embolization through the choroidal arteries between 2006 and 2014. Embolization was performed as a palliative procedure before open surgery or Gamma Knife radiosurgery. Computed tomography and MRI were performed the day after embolization to assess any surgical complications. The incidence and type of complications and their association with clinical outcomes were analyzed. RESULTS Decreased blood flow was achieved in all patients after embolization. Postoperative CT detected no hemorrhagic complications. In contrast, postoperative MRI detected that 4 of the 13 patients (30.7%) developed infarctions: 3 patients after embolization through the anterior choroidal artery, and 1 patient after embolization through the lateral posterior choroidal artery. Two of the 4 patients in whom embolization was from the cisternal segment of the anterior choroidal artery (proximal to the plexal point) developed symptomatic infarction of the posterior limb of the internal capsule, 1 of whom developed morbidity (7.7%). The treatment-related mortality rate was 0%. Additional treatment was performed in 12 patients: open surgery in 9 and Gamma Knife radiosurgery in 3 patients. Complete obliteration was confirmed by angiography at the last follow-up in 10 patients. Recurrent bleeding from the AVMs did not occur in any of the cases during the follow-up period. CONCLUSIONS Ischemic complications are possible following the embolization of cerebral AVMs through the choroidal artery, even with modern neurointerventional devices and techniques. Although further study is needed, embolization through the choroidal artery may be an appropriate treatment option when the risk of surgery or radiosurgery is considered to outweigh the risk of embolization.

scholarly journals Curative and adjunctive AVM Onyx embolization of AVMs through the choroidal arteries

2017 ◽  
Vol 23 (4) ◽  
pp. 392-398 ◽  
Author(s):  
Xianli Lv ◽  
Xiulan Hu ◽  
Wei Li ◽  
Hongwei He ◽  
Chuhan Jiang ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Endovascular Embolization ◽  
Anterior Choroidal Artery ◽  
Complete Obliteration ◽  
Lateral Posterior ◽  
Cerebral Avms ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Deep Location

Objective The anterior or posterior choroidal artery is often recruited to supply deep location arteriovenous malformations (AVMs). This study is to report curative and adjunctive AVM Onyx embolization through these arteries. Methods This study retrospectively reviewed six patients with cerebral AVMs who underwent endovascular embolization through the choroidal arteries between October 2015 and October 2016. Embolization was performed as a curative procedure in five patients and adjunctive procedure in one patient. Results Four patients underwent embolization through the anterior choroidal artery (AchA), and two patients underwent embolization through the lateral posterior choroidal artery (LPchA). One of the four patients in whom embolization was from the AchA (distal to the plexal point) developed transient hemiparesis. Complete obliteration was confirmed by angiography at the last follow-up in five patients. Conclusions Onyx embolization of cerebral AVMs through the choroidal arteries is possible as a curative or adjunctive procedure.

scholarly journals Classification of brain arteriovenous malformations located in motor-related areas based on location and anterior choroidal artery feeding

2021 ◽  
pp. svn-2020-000591
Author(s):  
Yuming Jiao ◽  
Hao Li ◽  
Weilun Fu ◽  
Jiancong Weng ◽  
Ran Huo ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Internal Capsule ◽  
Motor Deficit ◽  
Type I ◽  
Anterior Choroidal Artery ◽  
Posterior Limb ◽  
Type Iv ◽  
Anterior Choroidal ◽  
Choroidal Artery

ObjectiveSurgical management of arteriovenous malformations (AVMs) involving motor cortex or fibre tracts (M-AVMs) is challenging. This study aimed to construct a classification system based on nidus locations and anterior choroidal artery (AChA) feeding to pre-surgically evaluate motor-related and seizure-related outcomes in patients undergoing resection of M-AVMs.Methods and materialsA total of 125 patients who underwent microsurgical resection of M-AVMs were retrospectively reviewed. Four subtypes were identified based on nidus location: (I) nidus involving the premotor area and/or supplementary motor areas; (II) nidus involving the precentral gyrus; (III) nidus involving the corticospinal tract (CST) and superior to the posterior limb of the internal capsule; (IV) nidus involving the CST at or inferior to the level of posterior limb of the internal capsule. In addition, we divided type IV into type IVa and type IVb according to the AChA feeding. Surgical-related motor deficit (MD) evaluations were performed 1 week (short-term) and 6 months (long-term) after surgery.ResultsThe type I patients exhibited the highest incidence (62.0%) of pre-surgical epilepsy among the four subtypes. Multivariate analysis showed that motor-related area subtypes (p=0.004) and diffuse nidus (p=0.014) were significantly associated with long-term MDs. Long-term MDs were significantly less frequent in type I than in the other types. Type IV patients acquired the highest proportion (four patients, 25.0%) of long-term poor outcomes (mRS >2). Type IVb patients showed a significantly higher incidence of post-surgical MDs than type IVa patients (p=0.041). The MDs of type III or IV patients required more recovery time. Of the 62 patients who had pre-surgical seizures, 90.3% (56/62) controlled their seizures well and reached Engel class I after surgery.ConclusionsCombining the consideration of location and AChA feeding, the classification for M-AVMs is a useful approach for predicting post-surgical motor function and decision-making.

The anterior choroidal artery

1978 ◽  
Vol 14 (2) ◽  
pp. 160
Author(s):  
SY Rho ◽  
SH Cha ◽  
WH Lee ◽  
JS Kim
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

scholarly journals Paracentral homonymous hemianopic scotoma caused by anterior choroidal artery infarction

QJM ◽  
2021 ◽  
Author(s):  
A Mitsutake ◽  
Y Nagashima ◽  
H Mori ◽  
H Sawamura ◽  
T Toda
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Management of an Uncommon Complication: Anterior Choroidal Artery Occlusion by Posterior Clinoid Process Detected Through Intraoperative Monitoring After Clipping of Paraclinoid Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Walter Marani ◽  
Francisco Mannará ◽  
Kosumo Noda ◽  
Tomomasa Kondo ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Intraoperative Monitoring ◽  
Motor Evoked Potential ◽  
Japanese Woman ◽  
Motor Deficits ◽  
Anterior Choroidal Artery ◽  
Diffusion Weighted Images ◽  
Ct Angiogram ◽  
Paraclinoid Aneurysms ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract Despite technological advances in endovascular therapy, surgical clipping of paraclinoid aneurysms remains an indispensable treatment option and has an acceptable profile risk. Intraoperative monitoring of motor and somatosensory evoked potentials has proven to be an effective tool in predicting and preventing postoperative motor deficits during aneurysm clipping.1,2 We describe the case of a 61-yr-old Japanese woman with a history of hypertension and smoking. During follow-up for bilateral aneurysms of ophthalmic segment of the internal carotid artery (ICA), left-sided aneurysm growth was detected. A standard pterional approach with extradural clinoidectomy was used to approach the aneurysm. After clipping, a significant intraprocedural change in motor evoked potential (MEP) amplitude was observed despite native vessel patency was confirmed through micro-Doppler and indocyanine green video angiography.3-5 After extensive dissection of the sylvian fissure and exposure of the communicating segment of ICA, the anterior choroidal artery was found to be compressed and occluded by the posterior clinoid because of an inadvertent shift of the ICA after clip application and removal of brain retractors. Posterior clinoidectomy was performed intradurally with microrongeur and MEP amplitude returned readily to baseline values. Computed tomography (CT) angiogram demonstrated complete exclusion of the aneurysm, and magnetic resonance imaging (MRI) was negative for postoperative ischemic lesions on diffusion weighted images. The patient tolerated the procedure well and was discharged home on postoperative day 3 with modified Rankin Scale (mRS) 0. The patient signed the Institutional Consent Form to undergo the surgical procedure and to allow the use of her images and videos for any type of medical publications.

Sign in / Sign up

Export Citation Format

Share Document