Endovascular Embolization of Visceral Artery Aneurysms with Ethylene-vinyl Alcohol (Onyx): A Case Series

2006 ◽  
Vol 29 (6) ◽  
pp. 1125-1128 ◽  
Author(s):  
M.J. Bratby ◽  
E.D. Lehmann ◽  
J. Bottomley ◽  
D.O. Kessel ◽  
A.A. Nicholson ◽  
...  
Keyword(s):  
Vinyl Alcohol ◽  
Case Series ◽  
Endovascular Embolization ◽  
Visceral Artery ◽  
Ethylene Vinyl Alcohol ◽  
Visceral Artery Aneurysms

scholarly journals Complex Renal Arteriovenous Malformation (AVM) Embolization using Ethylene Vinyl Alcohol (EVOH) Copolymer and a Balloon Microcatheter

2019 ◽  
Vol 03 (02) ◽  
pp. 134-138
Author(s):  
Heather Kate Moriarty ◽  
Warren Clements ◽  
Tim Joseph ◽  
Anoop Madan ◽  
Tuan Phan
Keyword(s):  
Arteriovenous Malformation ◽  
Vinyl Alcohol ◽  
Balloon Catheter ◽  
Horseshoe Kidney ◽  
Endovascular Embolization ◽  
Effective Procedure ◽  
Arterial Supply ◽  
Embolic Material ◽  
Ethylene Vinyl Alcohol ◽  
Renal Arteriovenous Malformation

AbstractOccurrence of a symptomatic renal arteriovenous malformation (AVM) is rare. The authors present the case of a patient with a background of Turner's syndrome, hemophilia B, and horseshoe kidney, who presented with hematuria and was successfully treated with endovascular embolization. The use of a microballoon catheter Scepter XC (Microvention, Inc.) to safely embolize the feeding arterial supply, using ethylene vinyl alcohol (EVOH) copolymer (Onyx; Medtronic/ev3) has not, to the authors’ knowledge, previously been described for the treatment of renal AVM. This novel use of an occlusal balloon catheter is permitted by the precipitation rate of Onyx, and allowed a safe and effective procedure, reducing the risk of reflux, allowing a forward push of embolic material in a controlled manner.

The failure of preoperative ethylene-vinyl alcohol copolymer embolization to improve outcomes in arteriovenous malformation management: case series

2013 ◽  
Vol 118 (5) ◽  
pp. 969-977 ◽  
Author(s):  
Michael Kerin Morgan ◽  
Andrew Stewart Davidson ◽  
Stavros Koustais ◽  
Mary Simons ◽  
Elizabeth Anne Ritson
Keyword(s):  
Vinyl Alcohol ◽  
Adverse Outcome ◽  
Case Series ◽  
Adverse Outcomes ◽  
Selective Embolization ◽  
Ethylene Vinyl Alcohol ◽  
Ethylene Vinyl Alcohol Copolymer ◽  
Brain Avms ◽  
Second Period ◽  
Grade Iii

Object Ethylene-vinyl alcohol copolymer embolization is increasingly used preoperatively in the resection of brain arteriovenous malformations (AVMs). However, the case for embolization improving the outcome of resection has not been evaluated. In this paper the authors set out to compare outcomes after surgery for brain AVMs in 2 consecutive periods of practice. In the first period, selective embolization was used without the use of ethylene-vinyl alcohol copolymer. In the second period, selective embolization with ethylene-vinyl alcohol copolymer was performed. Methods A consecutive case series (prospectively collected data) was retrospectively analyzed. Adverse outcomes were considered to be an outcome modified Rankin Scale score greater than 2 due to embolization or surgery. Results A total of 538 surgical cases were included. The percentages of adverse outcomes were as follows: 0.34% for Spetzler-Martin AVMs less than Grade III (1 of 297 cases); 5.23% (95% CI 2.64%–9.78%) for Grade III AVMs (9 of 172 cases); and 17% (95% CI 10%–28%) for AVMs greater than Grade III (12 of 69 cases). There was no improvement in outcomes from the first period to the second period. The adverse outcome for Grade III brain AVMs in the first period was 5.2% (7 of 135 cases) and in the second period (after ethylene-vinyl alcohol copolymer was introduced) it was 5.4% (2 of 37 cases). For AVMs greater than Grade III, the adverse outcome was 12% (6 of 49 cases) in the first period and 30% (6 of 20 cases) in the second period. Conclusions Outcomes for brain AVM surgery were not improved by ethylene-vinyl alcohol copolymer embolization. Preoperative embolization of high-grade AVMs with an ethylene-vinyl alcohol copolymer did not prevent those hemorrhagic complications which embolization is hypothesized to prevent based on theoretical speculations but not demonstrated in practice.

Endovascular Treatment of Visceral Artery Aneurysms

2002 ◽  
Vol 9 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Andreas Gabelmann ◽  
Johannes Görich ◽  
Elmar M. Merkle
Keyword(s):  
Endovascular Treatment ◽  
Necrotizing Pancreatitis ◽  
Artery Aneurysm ◽  
Endovascular Embolization ◽  
Visceral Artery ◽  
Recurrent Bleeding ◽  
Visceral Artery Aneurysms ◽  
Long Term Follow Up ◽  
Transcatheter Coil Embolization

Purpose: To review a 10-year experience with endovascular embolization of visceral artery aneurysms. Methods: Twenty-five patients (13 men; mean age 52.1 years, range 31–80) presented with VAAs of varying locations and etiologies: 10 splenic, 3 gastroduodenal, 2 pancreaticoduodenal, 3 hepatic, 3 superior mesenteric, 2 celiac, 1 left gastric, and 1 jejunoileal. Ten patients were asymptomatic; 7 aneurysms were ruptured. Transcatheter coil embolization was the treatment of choice in all patients. Results: Coil placement was initially (<7 days) successful in 23 (92%) patients. One superior mesenteric artery aneurysm remained perfused, and recurrent bleeding occurred 2 days after intervention in 1 case, but repeated embolization excluded the aneurysm. One patient with necrotizing pancreatitis died from sepsis 10 days after endovascular treatment and surgery (4% 30-day mortality). Long-term follow-up revealed excellent results after an average 48.7 months (range 14–75) with only 1 recurrence after 12 months. Conclusions: Embolotherapy is the treatment of choice in visceral artery aneurysms, regardless of etiology, location, or clinical presentation.

scholarly journals Splenic artery aneurysm, case series of seven patients

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Javad Salimi ◽  
Zahra Omrani ◽  
Roozbeh Cheraghali
Keyword(s):  
Splenic Artery ◽  
Endovascular Procedures ◽  
Case Series ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm ◽  
Visceral Artery ◽  
Endovascular Techniques ◽  
Hybrid Surgery ◽  
First Choice ◽  
Visceral Artery Aneurysms

Abstract Splenic artery aneurysms (SAA) account for 46–60% of all visceral artery aneurysms. Small SAAs are usually asymptomatic, but giant aneurysms are more likely to cause symptoms and can result in life-threatening complications. Treatment of a splenic artery aneurysms includes laparotomy, laparoscopy or endovascular techniques. Case presentation: In this article, seven interesting cases of splenic artery aneurysms in different size and parts of artery and various interventions (open, endovascular and hybrid surgery) are discussed. Six of the patients were male. Five of them had giant SAAs (≥5 cm). Two patients underwent hybrid surgery. Coil embolization was carried out for one patient. All seven patients discharged with no procedure-related complications. Endovascular procedures considered as a first choice of treatment for splenic artery aneurysm. Open surgery is reserved mostly for the treatment of complications or if the endovascular techniques fail, lack of availability of endovascular procedures or allergy to contrast medium.

Ruptured Left Gastric Artery Aneurysm Associated with Fibromuscular Dysplasia

2021 ◽  
pp. 153857442110542
Author(s):  
Kelvin K. F. Ho ◽  
Gary Foo ◽  
John Bingley ◽  
Kendal Redmond
Keyword(s):  
Fibromuscular Dysplasia ◽  
Artery Aneurysm ◽  
Left Gastric Artery ◽  
Endovascular Embolization ◽  
Visceral Artery ◽  
Gastric Artery ◽  
Atherosclerotic Vascular Disease ◽  
Clinical Notes ◽  
Visceral Artery Aneurysms ◽  
The Impact

Background: Fibromuscular dysplasia is a non-inflammatory, non-atherosclerotic vascular disease that commonly affects renal and carotid arteries but involvement of virtually any vascular territory has been observed. Research Design/ Study sample: This is a case report of a ruptured left gastric artery aneurysm as the first presentation of fibromuscular dysplasia. Data collection: After written consent from the patient, relevant clinical notes and imaging were retrospectively reviewed and critically analysed. Purpose: This case reiterates the importance of considering fibromuscular dysplasia as an uncommon cause of visceral artery aneurysms. In addition, this case shows that the impact of visceral artery vasospasm on endovascular access should not be underestimated and subsequent attempts can be successful after a period of resuscitation. Results: After initial difficulty in endovascular treatment due to visceral vasospasm, the case was successfully managed with with staged open ligation and endovascular embolization after a period of resuscitation. Conclusions: FMD is an important differential diagnosis to consider in cases of visceral aneurysms.

scholarly journals Endovascular transarterial embolization of cerebral arteriovenous malformation with ethylene-vinyl alcohol copolymer

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1
Author(s):  
Lee A. Tan ◽  
Andrew K. Johnson ◽  
Kiffon M. Keigher ◽  
Roham Moftakhar ◽  
Demetrius K. Lopes
Keyword(s):  
Vinyl Alcohol ◽  
Transarterial Embolization ◽  
Treatment Options ◽  
Endovascular Embolization ◽  
Ethylene Vinyl Alcohol ◽  
Ethylene Vinyl Alcohol Copolymer ◽  
Microsurgical Resection ◽  
Vital Component ◽  
Risk Of Hemorrhage ◽  
Annual Risk

Cerebral arteriovenous malformations (AVMs) have an estimated 2–4% annual risk of hemorrhage. Treatment options for AVMs include microsurgical resection, stereotactic radiosurgery, and endovascular embolization. As endovascular technology and techniques continue to advance and mature, endovascular embolization is becoming an increasingly vital component of AVM treatment not only as a presurgical treatment to reduce microsurgical risks, but also as a stand-alone curative method in some cases. This case illustrates the successful and curative transarterial embolization of a right frontal AVM in a 17-year-old boy with ethylene-vinyl alcohol copolymer (Onyx).The video can be found here: http://youtu.be/L4hE1MvCZCY.

scholarly journals Ruptured Splenic Artery Aneurysms and the Use of an Adapted Fast Protocol in Reproductive Age Women with Hemodynamic Collapse: Case Series

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Hope T. Jackson ◽  
Silviu C. Diaconu ◽  
Patrick J. Maluso ◽  
Bruce Abell ◽  
Juliet Lee
Keyword(s):  
Splenic Artery ◽  
Case Series ◽  
Reproductive Age ◽  
Bedside Ultrasound ◽  
Visceral Artery ◽  
Fetal Mortality ◽  
Female Population ◽  
Hepatic Rupture ◽  
Visceral Artery Aneurysms

Nontraumatic symptomatic hypotension in all patients requires prompt diagnosis and appropriate treatment for optimum outcome. The female population specifically has an expanded differential diagnosis that should be considered when these patients present with hemodynamic collapse. While the most common causes of hypotension in pregnant patients are dehydration, ruptured ectopic pregnancy, and placental and uterine abnormalities, less common nonobstetrical etiologies such as hepatic rupture and ruptured abdominal and visceral artery aneurysms should also be considered. Splenic artery aneurysms are associated with high rates of mortality and in cases of pregnancy, maternal and fetal mortality. These high rates can be attributed to the asymptomatic nature of the aneurysm, rapid deterioration after rupture, and frequent misdiagnosis. In patients with hemodynamic collapse, the role of traditional imaging is limited mainly due to the critical condition of the patient. Bedside ultrasound has emerged as a diagnostic imaging resource in patients with undifferentiated hypotension and in patients with traumatic injuries. However, its use has not been studied specifically in the female population. We present two patients with ruptured splenic artery aneurysms, discuss the role of bedside ultrasound in their management, and introduce a new ultrasound protocol for use in reproductive age female patients with hemodynamic collapse.

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