scholarly journals Acute Endovascular Management of a Ruptured Choroidal Artery Arteriovenous Malformation in a Peripartum COVID-19-Positive Patient

2022 ◽  
Author(s):  
Gaurav Tyagi ◽  
Karthik Kulanthaivelu ◽  
Jitender Saini ◽  
Aravind Gowda ◽  
Dwarakanath Srinivas
Keyword(s):  
Arteriovenous Malformation ◽  
Neonatal Intensive Care ◽  
External Ventricular Drain ◽  
Gamma Knife Radiosurgery ◽  
Artery Aneurysm ◽  
Patient Profile ◽  
Cerebrospinal Fluid Diversion ◽  
Emergency Cesarean ◽  
Isolation Ward ◽  
Choroidal Artery

AbstractCoronavirus disease 2019 (COVID-19) pandemic has led to significant reduction in specialty care causing delayed presentations and decreased resources for elective procedures. We present here a case of a 29-year-old female, 34 weeks primigravida who presented with a twice ruptured right choroidal artery arteriovenous malformation (AVM). She underwent an immediate external ventricular drain placement followed by an emergency cesarean. She underwent a diagnostic angiogram showing a right choroidal AVM with a feeder artery aneurysm along with small supply to its cortical component by the M4 segment of right middle cerebral artery, draining into the basal vein of Rosenthal and vein of Labbe. The patient underwent embolization of the aneurysm and the choroidal feeders. She improved symptomatically following the procedure with external cerebrospinal fluid diversion for 5 days. At follow-up magnetic resonance imaging, the residual AVM remained stable and is planned for Gamma knife radiosurgery. The newborn was taken care at a neonatal intensive care unit and was started on breastfeed on 16th day of birth once the mother had a negative COVID-19 reverse transcription polymerase chain reaction. In this study, we highlight our experience with the above-mentioned patient profile, the multidisciplinary effort during the pandemic, and the measures taken (isolation ward, COVID-19 dedicated Cath-lab and personal precautions) and advised for tackling COVID-19 patients for endovascular procedures.

Distal anterior choroidal artery aneurysm associated with an arteriovenous malformation. intraoperative localization and treatment

2000 ◽  
Vol 53 (6) ◽  
pp. 546-551 ◽  
Author(s):  
Kiyoyuki Yanaka ◽  
Koji Tsuboi ◽  
Keishi Fujita ◽  
Kazuyasu Aoki ◽  
Sadayuki Takeuchi ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Artery Aneurysm ◽  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Intraoperative Localization ◽  
Choroidal Artery

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 Placental Infection and Inflammation Leading to Fetal Distress and Neonatal Multi-Organ Failure in an Asymptomatic Woman

2020 ◽  
Author(s):  
Sam Schoenmakers ◽  
Pauline Snijder ◽  
Robert M Verdijk ◽  
Thijs Kuiken ◽  
Sylvia S M Kamphuis ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Vertical Transmission ◽  
Neonatal Intensive Care ◽  
Quantitative Polymerase Chain Reaction ◽  
Antigen Expression ◽  
Fetal Distress ◽  
Adverse Outcomes ◽  
Placental Infection ◽  
Emergency Cesarean ◽  
Increased Risk

Abstract Background In general, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy is not considered to be an increased risk for severe maternal outcomes but has been associated with an increased risk for fetal distress. Maternal-fetal transmission of SARS-CoV-2 was initially deemed uncertain; however, recently a few cases of vertical transmission have been reported. The intrauterine mechanisms, besides direct vertical transmission, leading to the perinatal adverse outcomes are not well understood. Methods Multiple maternal, placental, and neonatal swabs were collected for the detection of SARS-CoV-2 using real-time quantitative polymerase chain reaction (RT-qPCR). Serology of immunoglobulins against SARS-CoV-2 was tested in maternal, umbilical cord, and neonatal blood. Placental examination included immunohistochemical investigation against SARS-CoV-2 antigen expression, with SARS-CoV-2 ribonucleic acid (RNA) in situ hybridization and transmission electron microscopy. Results RT-qPCRs of the oropharynx, maternal blood, vagina, placenta, and urine were all positive over a period of 6 days, while breast milk, feces, and all neonatal samples tested negative. Placental findings showed the presence of SARS-CoV-2 particles with generalized inflammation characterized by histiocytic intervillositis with diffuse perivillous fibrin depositions with damage to the syncytiotrophoblasts. Conclusions Placental infection by SARS-CoV-2 leads to fibrin depositions hampering fetal-maternal gas exchange with resulting fetal distress necessitating a premature emergency cesarean section. Postpartum, the neonate showed a fetal or pediatric inflammatory multisystem-like syndrome with coronary artery ectasia temporarily associated with SARS-CoV-2 for which admittance and care on the neonatal intensive care unit (NICU) were required, despite being negative for SARS-CoV-2. This highlights the need for awareness of adverse fetal and neonatal outcomes during the current coronavirus disease 2019 pandemic, especially considering that the majority of pregnant women appear asymptomatic.

Vascular Reconstruction of a Brachial Artery Aneurysm Proximally to an Arteriovenous Malformation

2019 ◽  
Vol 54 (1) ◽  
pp. 75-79
Author(s):  
Curtis Woodford ◽  
Elizabeth Tai ◽  
Sebastian Mafeld ◽  
Husain A. Al-Mubarak ◽  
Arash Jaberi ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Radial Artery ◽  
Brachial Artery ◽  
Arteriovenous Malformations ◽  
Femoral Vein ◽  
Artery Aneurysm ◽  
Vascular Reconstruction ◽  
Endovascular Embolization ◽  
Antecubital Fossa ◽  
Interposition Graft

Brachial artery aneurysms and arteriovenous malformations (AVM) are limb-threatening vascular anomalies. This patient presented with a bilobed brachial artery aneurysm in the antecubital fossa proximally to an AVM arising from the dorsal interosseous and ulnar arteries that had been treated with endovascular embolization, leaving the hand solely supplied by the radial artery. The aneurysm continued to increase in size and imaging revealed concomitant thrombus. A femoral vein interposition graft was used to repair the aneurysm, and postoperatively, the patient retained full left arm function.

scholarly journals Ruptured Bilateral Pericallosal Artery Aneurysm in Mirror Position: Case Report

2018 ◽  
Vol 37 (03) ◽  
pp. 263-266
Author(s):  
Lucas Meguins ◽  
Linoel Valsechi ◽  
Ronaldo Fernandes ◽  
Dionei Morais ◽  
Antonio Spotti
Keyword(s):  
Case Report ◽  
Subarachnoid Hemorrhage ◽  
External Ventricular Drain ◽  
Artery Aneurysm ◽  
Operative Management ◽  
Neurological Deficits ◽  
Pericallosal Artery ◽  
Digital Subtraction Arteriography ◽  
The Many ◽  
The Right

Introduction Pericallosal artery (PA) aneurysms represent 2 to 9% of all intracranial aneurysms, and their management remains difficult. Objective The aim of the present study is to describe the case of an adult woman with subarachnoid hemorrhage and bilateral PA aneurysm in mirror position. Case Report A 46-year-old woman was referred to our institution 20 days after a sudden severe headache. She informed that she was treating her arterial hypertension irregularly, and consumed ∼ 20 cigarettes/day. The patient was neurologically intact at admission. A non-contrast computed tomography (CT) on the first day of the onset of the symptoms revealed hydrocephaly and subarachnoid hemorrhage (Fisher III). An angio-CT/digital subtraction arteriography showed bilateral PA aneurysms in mirror position. The patient was successfully treated with surgery via the right interhemispheric approach (because the surgeon is right-handed); the surgeon performed the proximal control with temporary clipping, and introduced an external ventricular drain at the end of the surgery. The patient was discharged on the fourth postoperative day without any additional neurological deficits or ventricular shunts. Conclusion Ruptured PA aneurysm is a surgically challenging aneurysm due to the many anatomical nuances and risk of rebleeding. However, the operative management of ruptured bilateral PA aneurysms is feasible and effective.

scholarly journals Giant splenic artery aneurysm associated with arteriovenous malformation

2006 ◽  
Vol 44 (6) ◽  
pp. 1345-1349 ◽  
Author(s):  
Aditya Agrawal ◽  
Richard Whitehouse ◽  
Robert W. Johnson ◽  
Titus Augustine
Keyword(s):  
Arteriovenous Malformation ◽  
Splenic Artery ◽  
Artery Aneurysm ◽  
Splenic Artery Aneurysm

scholarly journals Disappearance of a ruptured distal anterior choroidal artery aneurysm following surgical revascularization for moyamoya disease with hemorrhagic onset

Nosotchu ◽  
2012 ◽  
Vol 34 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Keisuke Toyoda ◽  
Shuji fukuda ◽  
Shunsuke Ishizaka ◽  
Tomonori Takeshita ◽  
Kentaro Hayashi ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Artery Aneurysm ◽  
Anterior Choroidal Artery ◽  
Surgical Revascularization ◽  
Anterior Choroidal ◽  
Choroidal Artery

scholarly journals Bibliometric analysis of the top-100 most cited articles on the radiosurgical management of cerebral arteriovenous malformation

2020 ◽  
Vol 11 ◽  
pp. 477
Author(s):  
Ali Alkhabiry ◽  
Othman T. Almutairi ◽  
Turki Elarjani ◽  
Mohammed Bafaquh ◽  
Hossam Alassaf ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
The United States ◽  
Cerebral Arteriovenous Malformations ◽  
Exclusion Criteria ◽  
Scholarly Impact ◽  
English Articles ◽  
Conference Papers ◽  
Specific Search

Background: Radiosurgery is an effective, alternative treatment modality in managing patients with cerebral arteriovenous malformations (AVMs). The present study aims to highlight the scholarly impact of the top-100 most cited articles on the radiosurgical management of AVMs. Methods: A title-specific search using the keyword “arteriovenous malformation” was conducted in the Scopus database. The outcome of the search was rearranged based on the citations count. Articles were categorized into four entities; clinical, gamma knife radiosurgery, linear accelerator (LINAC) radiosurgery, and proton beam radiosurgery. The exclusion criteria were applied to spinal or non-intracranial AVM, conference papers, non-English articles predominantly discussing the endovascular or microsurgical management. Results: The top-100 articles on the radiosurgical management of AVM were published between 1972 and 2016. Approximately one-third of the publications were produced between 1995 and 2000. The average citations per year for all papers were seven. The most-studied entity was pertinent to the clinical application of gamma knife radiosurgery in AVM (68%). The United States was the most active country in studying the radiosurgical application in AVM. The Journal of Neurosurgery published approximately one-third of the most-cited articles in the list. The top-3 most contributing authors, publishing 80% of articles in the list, were Lunsford et al. Conclusion: The radiosurgical management of AVMs evolved significantly throughout the years. Identifications of the publication trends facilitate the acquisition of evidence-based articles for authors investigating various radiosurgical techniques in the treatment of AVMs.

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