scholarly journals Estimation of the number of feeding arteries of spinal arteriovenous malformations by using three-dimensional digital subtraction angiography

2018 ◽  
Vol 28 (4) ◽  
pp. 842-848 ◽  
Author(s):  
Soichiro Takamiya ◽  
Toshiya Osanai ◽  
Toshitaka Seki ◽  
Noriyuki Fujima ◽  
Kazutoshi Hida ◽  
...  
2021 ◽  
Author(s):  
Serge Marbacher ◽  
Matthias Halter ◽  
Deborah R Vogt ◽  
Jenny C Kienzler ◽  
Christian T J Magyar ◽  
...  

Abstract BACKGROUND The current gold standard for evaluation of the surgical result after intracranial aneurysm (IA) clipping is two-dimensional (2D) digital subtraction angiography (DSA). While there is growing evidence that postoperative 3D-DSA is superior to 2D-DSA, there is a lack of data on intraoperative comparison. OBJECTIVE To compare the diagnostic yield of detection of IA remnants in intra- and postoperative 3D-DSA, categorize the remnants based on 3D-DSA findings, and examine associations between missed 2D-DSA remnants and IA characteristics. METHODS We evaluated 232 clipped IAs that were examined with intraoperative or postoperative 3D-DSA. Variables analyzed included patient demographics, IA and remnant distinguishing characteristics, and 2D- and 3D-DSA findings. Maximal IA remnant size detected by 3D-DSA was measured using a 3-point scale of 2-mm increments. RESULTS Although 3D-DSA detected all clipped IA remnants, 2D-DSA missed 30.4% (7 of 23) and 38.9% (14 of 36) clipped IA remnants in intraoperative and postoperative imaging, respectively (95% CI: 30 [ 12, 49] %; P-value .023 and 39 [23, 55] %; P-value = <.001), and more often missed grade 1 (< 2 mm) clipped remnants (odds ratio [95% CI]: 4.3 [1.6, 12.7], P-value .005). CONCLUSION Compared with 2D-DSA, 3D-DSA achieves a better diagnostic yield in the evaluation of clipped IA. Our proposed method to grade 3D-DSA remnants proved to be simple and practical. Especially small IA remnants have a high risk to be missed in 2D-DSA. We advocate routine use of either intraoperative or postoperative 3D-DSA as a baseline for lifelong follow-up of clipped IA.


2017 ◽  
Vol 104 ◽  
pp. 619-627 ◽  
Author(s):  
Jan-Karl Burkhardt ◽  
Xiaolin Chen ◽  
Ethan A. Winkler ◽  
Daniel L. Cooke ◽  
Helen Kim ◽  
...  

2021 ◽  
Vol 12 ◽  
pp. 85
Author(s):  
Toshihiro Ishibashi ◽  
Fumiaki Maruyama ◽  
Issei Kan ◽  
Tohru sano ◽  
Yuichi Murayama

Background: Intraosseous arteriovenous fistula (AVF) is a rare clinical entity that typically presents with symptoms from their effect on surrounding structures. Here, we report a case of intraosseous AVF in the sphenoid bone that presented with bilateral abducens palsy. Case Description: A previously healthy man presented with tinnitus for 1 month, and initial imaging suspected dural AVF of the cavernous sinus. Four-dimensional digital subtraction angiography (4D-DSA) imaging and a three-dimensional (3D) fused image from the bilateral external carotid arteries revealed that the shunt was in a large venous pouch within the sphenoid bone that was treated through transvenous coil embolization. His symptoms improved the day after surgery. Conclusion: This is a case presentation of intraosseous AVF in the sphenoid bone and highlights the importance of 4D-DSA and 3D fused images for planning the treatment strategy.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Justin E Vranic ◽  
Parmede Vakil ◽  
Sameer A Ansari ◽  
Hunt H Batjer ◽  
Bernard R Bendok ◽  
...  

BACKGROUND: Cerebral digital subtraction angiography (DSA) has established impaired hemodynamic drainage of intracranial arteriovenous malformations (iAVM) as a risk factor for iAVM hemorrhage. Unlike conventional DSA, MR-DSA offers a noninvasive means of characterizing iAVM hemodynamics. We hypothesize that MR-DSA will demonstrate impaired drainage in iAVMs with history of rupture when compared to iAVMs without history of rupture. METHODS: Consecutive patients with untreated, DSA-confirmed iAVM underwent MR-DSA on a 3T Whole-body MR-scanner. For each iAVM, regions of interest (ROI) were drawn on all feeder arteries and draining veins. Time-density curves were constructed for each ROI. The arteriovenous malformation transit time (ATT) was defined for each ROI as the time between contrast arrival and peak intravascular contrast density on the MR time-density curve. The drainage of each iAVM was characterized by the ratio of the draining vein ATT to the mean feeder artery ATT. The ATT ratio was compared between iAVMs with history of hemorrhage and those without. Statistical analysis was performed using a Student’s unpaired t-test with p <0.05 defined as statistically significant. RESULTS: From May 2011 to April 2012, 13 patients (7M:6F, 40.6±13.8 years old) were enrolled in our study, with 3 patients presenting with history of hemorrhage and the remainder presenting with history of seizure, focal neurological deficit, headache, or as an incidental finding. The ATT ratio was significantly higher in iAVMs with history of hemorrhage than in those without (1.17±0.06 vs 0.95±0.02, p <2.9E-7). CONCLUSION: MR-DSA identifies impaired drainage in iAVMs with history of rupture without exposing patients to the procedural risks and ionizing radiation associated with cerebral DSA. FIGURE A: MR-DSA with feeder artery (red) and draining vein (yellow) labeled. FIGURE B: Time-density curves of the artery (red) and vein (yellow) from which vessel ATTs were derived.


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