Development of a huge varix following endovascular embolization for cerebellar arteriovenous malformation

1998 ◽  
Vol 39 (2) ◽  
pp. 189-192
Author(s):  
K. Mineura ◽  
H. Sasajima ◽  
Y. Itoh ◽  
M. Kowada ◽  
N. Tomura ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Arteriovenous Malformation ◽  
Rare Complication ◽  
Endovascular Embolization ◽  
Vein Of Galen ◽  
Dynamic Changes ◽  
Initial Stage ◽  
Basal Vein Of Rosenthal ◽  
Polyvinyl Alcohol Particles ◽  
Surgical Extirpation

We report on the case of a huge varix that developed after the endovascular embolization of a cerebellar arteriovenous malformation (AVM) with a single drainer. A 21-year-old male presented with trigeminal neuralgia which was caused by the dilated drainer of the AVM. A varix was found at the basal vein of Rosenthal 2 months after an initial stage of embolization with polyvinyl alcohol particles; it diminished after the surgical extirpation of the AVM The varix formation might have been facilitated by the stenosis in the vein of Galen and by the dynamic changes that followed the embolization This rare complication should be kept in mind when embolization is performed for AVMs with impaired venous outlets

The Management of Vein of Galen Aneurysmal Malformations

Neurosurgery ◽  
2006 ◽  
Vol 59 (suppl_5) ◽  
pp. S3-184-S3-194 ◽  
Author(s):  
Pierre L. Lasjaunias ◽  
Soke M. Chng ◽  
Marina Sachet ◽  
Hortensia Alvarez ◽  
Georges Rodesch ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Normal Growth ◽  
Venous Drainage ◽  
Treatment Method ◽  
Growth Conditions ◽  
Endovascular Embolization ◽  
Therapeutic Window ◽  
Vein Of Galen ◽  
Neurologically Normal ◽  
Level Of Understanding

Abstract OBJECTIVE: The vein of Galen aneurysmal malformation (VGAM) is a choroidal type of arteriovenous malformation involving the vein of Galen forerunner. This is distinct from an arteriovenous malformation with venous drainage into a dilated, but already formed, vein of Galen. Reports of endovascular treatment of VGAM in the literature approach the disease from a purely technical viewpoint and often fail to provide satisfactory midterm results. To focus the therapeutic challenge to a strictly morphological goal overlooks the fundamental aspects of neonatal and infant anatomy and fluid physiology. During the past 20 years, our approach to VGAM has remained the same. Our experience, based on 317 patients with VGAM who were studied in Hospital Bicêtre between October 1981 and October 2002, allows us to describe the angioarchitecture, natural history, and management of VGAM in neonates, infants, and children. METHODS: Of our cohort of 317 patients, 233 patients were treated with endovascular embolization; of these, 216 patients were treated in our hospital. The treatment method of choice was a transfemoral arterial approach to deliver glue at the fistulous zone. RESULTS: Of 216 patients, 23 died despite or because of the embolization (10.6%). Twenty out of the 193 (10.4%) surviving patients were severely retarded, 30 (15.6%) were moderately retarded, and 143 (74%) were neurologically normal on follow-up. CONCLUSION: Our data demonstrate that most treated children survive and undergo normal neurological development; an understanding of the clinical, anatomical, and pathophysiological features of VGAM has, therefore, reversed the former poor prognosis. Our level of understanding about the lesion allows us to predict most situations and remedy them by applying a strict evaluation protocol and working within an optimal therapeutic window. Patient selection and timing remain the keys in the management of this condition. It is more important to restore normal growth conditions than a normal morphological appearance, with the primary therapeutic objective being normal development in a child without neurological deficit.

Rare basal vein fistula with dilated vein of Galen

2012 ◽  
Vol 9 (3) ◽  
pp. 331-334 ◽  
Author(s):  
Srinivasan Paramasivam ◽  
Johanna T. Fifi ◽  
Rafael A. Ortiz ◽  
Yasunari Niimi ◽  
Alejandro Berenstein
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Male Infant ◽  
Normal Pregnancy ◽  
Endovascular Embolization ◽  
Vein Of Galen ◽  
Management Options ◽  
Excellent Outcome ◽  
Pregnancy And Delivery ◽  
Basal Vein Of Rosenthal

The authors present a rare case of arteriovenous fistula (AVF) of the basal vein of Rosenthal draining into a dilated vein of Galen managed by transarterial endovascular embolization. A male infant born at full term following a normal pregnancy and delivery with congestive heart failure, on investigation with MR imaging and MR angiography was found to have a basal vein of Rosenthal fistula with a dilated vein of Galen. His congestive heart failure was treated medically, and the AVF was managed electively at 10 months of age with successful transarterial endovascular embolization. The authors discuss the embryological aspects related to the pathological entity and the various clinical presentations, investigations, and management options. Management is primarily endovascular embolization; microsurgery is performed for a few selected cases, and radiosurgery has a limited role in older patients. Endovascular embolization is a safe and effective way to manage this malformation, with an excellent outcome if the AVF is eliminated by proper embolization at the fistulous point.

scholarly journals Dural arteriovenous fistula and arteriovenous malformation presenting as trigeminal neuralgia

2021 ◽  
Vol 14 (1) ◽  
pp. e240483
Author(s):  
Rashid Ahmed ◽  
Carlos Lopez ◽  
Karan Philip ◽  
Grahame Gould
Keyword(s):  
Trigeminal Neuralgia ◽  
Arteriovenous Malformation ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula

scholarly journals Giant arteriovenous malformation of the vein of Galen in an adult

1984 ◽  
Vol 22 (4) ◽  
pp. 382-386 ◽  
Author(s):  
Keith L. Black ◽  
Saeed M. Farhat
Keyword(s):  
Arteriovenous Malformation ◽  
Vein Of Galen

scholarly journals Pulmonary arteriovenous malformation (PAVM) embolization: prediction of angiographically-confirmed recanalization according to PAVM Diameter changes on CT

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jihoon Hong ◽  
Sang Yub Lee ◽  
Jung Guen Cha ◽  
Jae-Kwang Lim ◽  
Jongmin Park ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Case Series ◽  
Pulmonary Angiography ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Conventional Angiography ◽  
Receiver Operating Characteristic Curves ◽  
Vein Diameter ◽  
Diameter Reduction

Abstract Background To assess pulmonary arteriovenous malformation (PAVM) recanalization after embolization based on PAVM diameter changes on computed tomography (CT), with pulmonary angiography used as a gold standard. Methods A retrospective review was done of patients from 2008 to 2019 with a PAVM treated with endovascular embolization. The treatment outcome was determined by conventional angiography. Follow-up pulmonary angiography was performed when recanalization was suspected on CT, or embolization of all lesions in multiple PAVM patients could not be completed in a single session. Patients who had no preprocedural or follow-up CT were excluded. Draining vein, feeding artery, and venous sac diameter were measured on CT, and diameter reduction rates were compared with the widely-used, binary 70 % criteria. Results Forty-one patients with 114 PAVMs were treated during the study period. Eight patients with 50 PAVMs met the inclusion criteria. Mean vein, artery, and venous sac diameter reduction rates were as follows: 59.2 ± 9.3 %, 47.5 ± 10.6 %, and 62.6 ± 13.2 %, respectively, in the occluded group and 5.4 ± 19.5 %, 11.3 ± 17.7 %, and 26.8 ± 14.2 %, respectively, in the recanalized group. The area under the receiver operating characteristic curves for PAVM recanalization for the draining vein was 1.00, showing a better result than the artery (0.97) and sac (0.99). Patients showed > 42 % draining vein diameter reduction in the occluded group and < 32 % in the recanalized group. The widely-used 70 % criteria showed low specificity for predicting recanalization (draining vein, 7.3 %; venous sac, 41.7 %) but 100 % sensitivity for both the draining vein and venous sac. Conclusions The widely-used 70 % binary criteria showed limited performance in predicting outcomes in this angiographically-confirmed case series. Further investigations are warranted to establish a strategy for detecting recanalization after PAVM embolization.

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.

An intrathoracic arteriovenous malformation discovered as an extremely uncommon reason of neonatal congestive cardiac failure

2009 ◽  
Vol 19 (5) ◽  
pp. 530-533 ◽  
Author(s):  
Sigrun R. Hofmann ◽  
Matthias Weise ◽  
Katharina I. Nitzsche
Keyword(s):  
Arteriovenous Malformation ◽  
Cardiac Failure ◽  
Arteriovenous Malformations ◽  
Neonatal Period ◽  
High Flow ◽  
Congestive Cardiac Failure ◽  
Vein Of Galen ◽  
Prenatal Detection ◽  
First Case

AbstractCongenital arteriovenous malformations are rare causes of congestive cardiac failure in neonates. The most common sites are in the head and liver, but other sites include the thorax, the abdomen and the limbs. The onset of failure is usually not in the immediate neonatal period, but later on in life, albeit that lesions such as the arteriovenous malformation of the vein of Galen, and other arteriovenous malformations in different locations which produce high flow can present early. We describe here the first case, to the best of our knowledge, of prenatal detection of an intrathoracic arteriovenous malformation producing neonatal cardiac failure, which was successfully treated by surgery postnatally.

scholarly journals Dural Arteriovenous Shunt Development in Patients with Vein of Galen Malformation

2014 ◽  
Vol 20 (6) ◽  
pp. 781-790 ◽  
Author(s):  
Srinivasan Paramasivam ◽  
Yasunari Niimi ◽  
Dan Meila ◽  
Alejandro Berenstein
Keyword(s):  
Dura Mater ◽  
Endovascular Embolization ◽  
External Carotid ◽  
Vein Of Galen ◽  
Arteriovenous Fistulas ◽  
Sprouting Angiogenesis ◽  
Multi Stage ◽  
Dural Arteriovenous Shunt ◽  
Age Range

Dural arteriovenous fistulas (DAVF) associated with our series of patients with vein of Galen malformations (VOGM) are analyzed and discussed. We retrospectively analyzed 87 consecutive cases of VOGM treated between May 2002 and December 2011 and identified 26 patients with DAVF. We gathered information from the clinical case records, angiographic images, MRI on presentation and during follow-up. The findings were analyzed to aid discussion. Among 87 patients treated by multi-stage endovascular embolization, age range from newborn to 19 years, 26 (30%) had DAVF. In seven patients (8%), DAVF were found on initial angiogram and were all into the VOGM. Nineteen (21%) DAVF found on follow-up angiograms were all into the VOGM and distant locations. Sprouting and non-sprouting angiogenesis resulted in the formation of a network of vessels around partially thrombosed VOGM, recruiting blood from the surrounding dura mater resulting in a secondary network on the dura mater supplied by the blood vessels of dura mater in the region or from its natural collaterals. Embolization targeting DAVFs was done in 13 (52%) with complete cure in eight (32%) and recurrence in five (20%). Among 12 non-embolized patients (48%), eight (32%) had spontaneous regression with continued treatment of VOGM. In others, the DAVF either remained stable or progressed. DAVF associated with VOGM represent the dural response to angiogenic stimuli. They are observed to regress spontaneously or mature while continuing to treat the primary feeders of VOGM. It is important to include the external carotid system during angiograms. Persistent DAVF with residual VOGM that do not have access though the pial vessels are used as a conduit to treat the dural shunt and to achieve obliteration of residual VOGM at later stages of treatment.

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