Endovascular

2016 ◽  
pp. 47-60
Author(s):  
Badih Daou ◽  
Pascal Jabbour
Keyword(s):  
Arteriovenous Malformations ◽  
Recombinant Tissue Plasminogen Activator ◽  
Primary Treatment ◽  
Therapeutic Window ◽  
Endovascular Management ◽  
Endovascular Interventions ◽  
Clot Removal ◽  
Endovascular Approach ◽  
Aneurysm Coiling

Endovascular neurosurgery has evolved dramatically since the first description of aneurysm coiling in 1991 and is now employed as a primary treatment strategy for managing a multitude of cerebrovascular pathologies, including aneurysms, arteriovenous malformations (AVMs), and acute ischemic stroke. The endovascular approach offers an attractive, minimally invasive alternative for aneurysm treatment with low procedure-related morbidity and mortality. The durability and long-term efficacy of endovascular interventions is continuously evolving, especially with the introduction of newer coils, stents, and flow-diversion techniques. Endovascular management of AVMs can be used for presurgical embolization, preradiosurgical intervention, or palliative embolization or as a primary treatment for curative embolization, depending on the characteristics of the lesion. Advances in endovascular management of acute stroke have further increased the therapeutic window of recombinant tissue plasminogen activator administration using the intraarterial route and have led to the introduction of new devices for clot removal and vessel recanalization.

Endovascular management of intracranial blister aneurysms: spectrum and limitations of contemporary techniques

2014 ◽  
Vol 8 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Ramsey Ashour ◽  
Stephen Dodson ◽  
M Ali Aziz-Sultan
Keyword(s):  
Complication Rates ◽  
Endovascular Techniques ◽  
Parent Vessel ◽  
Endovascular Interventions ◽  
Scale Scores ◽  
Long Term Follow Up ◽  
Surgical Bypass ◽  
Endovascular Approach

BackgroundIntracranial blister aneurysms are rare lesions that are notoriously more difficult to treat than typical saccular aneurysms. High complication rates associated with surgery have sparked considerable interest in endovascular techniques, though not well-studied, to treat blister aneurysms.ObjectiveTo evaluate our experience using various endovascular approaches to treat blister aneurysms.MethodsAll consecutive blister aneurysms treated using an endovascular approach by the study authors over a 3-year period were retrospectively analyzed. A literature review was also performed.ResultsNine patients with blister aneurysms underwent 11 endovascular interventions. In various combinations, stents were used in 8/11, coils in 5/11, and Onyx in 3/11 procedures. At mean angiographic follow-up of 200 days, 8/9 aneurysms were completely occluded by endovascular means alone requiring no further treatment and 1/9 aneurysms required surgical bypass/trapping after one failed surgical and two failed endovascular treatments. At mean clinical follow-up of 416 days, modified Rankin Scale scores were improved in six patients, stable in two, and worsened in one patient. One complication occurred in 11 procedures (9%), resulting in a permanent neurologic deficit. No unintended endovascular parent vessel sacrifice, intraprocedural aneurysmal ruptures, antiplatelet-related complications, post-treatment aneurysmal re-ruptures, or deaths occurred.ConclusionThis series highlights both the spectrum and limitations of endovascular techniques currently used to treat blister aneurysms, including a novel application of stent-assisted Onyx embolization. Long-term follow-up and experience in larger studies are required to better define the role of endovascular therapy in the management of these difficult lesions.

Electrocardiogram Recognition and Ablation of Atrial Tachycardia

2011 ◽  
Vol 3 (1) ◽  
pp. 80
Author(s):  
Alexander Feldman ◽  
Jonathan M Kalman ◽  
◽  
Keyword(s):  
Catheter Ablation ◽  
Atrial Tachycardia ◽  
Primary Treatment ◽  
P Wave ◽  
Wave Morphology ◽  
Focal Atrial Tachycardia ◽  
Mapping Techniques ◽  
Electrocardiogram Ecg ◽  
Surface Electrocardiogram

Focal atrial tachycardia (AT) is a relatively uncommon cause of supraventricular tachycardia, but when present is frequently difficult to treat medically. Atrial tachycardias tend to originate from anatomically determined atrial sites. The P-wave morphology on surface electrocardiogram (ECG) together with more sophisticated contemporary mapping techniques facilitates precise localisation and ablation of these ectopic foci. Catheter ablation of focal AT is associated with high long-term success and may be viewed as a primary treatment strategy in symptomatic patients.

Endovascular Solutions for Iliac and Lower Extremity Junctional Injuries

2017 ◽  
Vol 1 (1) ◽  
pp. 22-27
Author(s):  
Edwin R Faulconer ◽  
Rachel M Russo ◽  
Anders J Davidson ◽  
Meryl A Simon ◽  
Erik S DeSoucy ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Open Surgery ◽  
Management Strategies ◽  
Balloon Occlusion ◽  
Vascular Injuries ◽  
Endovascular Management ◽  
Review Of The Literature ◽  
Junctional Zone ◽  
Endovascular Interventions ◽  
Direct Pressure

Hemorrhage is the second leading cause of death in trauma and non-compressible torso hemorrhage is the leading cause of preventable death within this population. Vascular injuries to the pelvis and lower extremity junctional zone may be difficult to control with direct pressure and complex to approach with open surgery. Endovascular interventions such as balloon occlusion, stenting and embolization are potential alternatives or adjuncts to traditional open surgery in patients with blunt or penetrating vascular injuries to the pelvis. This review of the literature will outline contemporary endovascular management strategies for iliac and junctional zone injuries.

scholarly journals Endovascular Management of Cerebral Arteriovenous Malformations: Technical and Clinical Outcome

2020 ◽  
Author(s):  
Ahmed Attia Ahmed Hassan ◽  
Ali Hassan Elmokadem ◽  
Ahmed Bahaa Elden Elserwi ◽  
Mohamed Metwally Abo El Atta ◽  
Talal Ahmed Youssef Amer
Keyword(s):  
Clinical Outcome ◽  
Arteriovenous Malformations ◽  
Endovascular Management ◽  
Cerebral Arteriovenous Malformations

scholarly journals Non-coronary Interventions: An Introduction to Peripheral Arterial Interventions

2016 ◽  
Vol 11 (2) ◽  
pp. 128
Author(s):  
Brock Cookman ◽  
Suhail Allaqaband ◽  
Tonga Nfor ◽  
◽  
◽  
...  
Keyword(s):  
Strong Relationship ◽  
Ageing Population ◽  
Peripheral Vascular ◽  
Endovascular Interventions ◽  
Cardiovascular Morbidity And Mortality ◽  
Vascular Beds ◽  
Peripheral Arterial ◽  
Peripheral Artery Diseases ◽  
Broad Understanding

With an ageing population, the burden of peripheral artery diseases (PADs) is increasing. The treatment of these diseases has largely been performed by interventional radiologists, vascular surgeons and interventional cardiologists. Due to the strong relationship between PAD and overall cardiovascular morbidity and mortality, cardiologists need to play a greater role in the management of PAD. The physician who cares for the patient with peripheral vascular disease should have a broad understanding of atherosclerotic disease involving all vascular beds. Endovascular interventions play a major role in relieving symptoms and reducing morbidity related to PAD, but long-term optimal medical treatment is an essential determinant of prognosis. This paper reviews current endovascular/percutaneous interventions for PAD.

scholarly journals Persistence of pulmonary arteriovenous malformations after successful embolotherapy with Amplatzer vascular plug: long-term results

2016 ◽  
Vol 22 (4) ◽  
pp. 358-364 ◽  
Author(s):  
Ahmed Kamel Abdel Aal ◽  
Rafik Mohamed Ibrahim ◽  
Amr Soliman Moustafa ◽  
Maysoon Farouk Hamed ◽  
Souheil Saddekni
Keyword(s):  
Arteriovenous Malformations ◽  
Amplatzer Vascular Plug ◽  
Long Term Results ◽  
Pulmonary Arteriovenous Malformations ◽  
Vascular Plug

scholarly journals A Rare Case of Persistent Lactic Acidosis in the ICU: Glycogenic Hepatopathy and Mauriac Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kirsten S. Deemer ◽  
George F. Alvarez
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acidosis ◽  
Rare Case ◽  
Hemoglobin A1c ◽  
Blood Glucose Control ◽  
Primary Treatment ◽  
High Dose ◽  
Single Feature ◽  
Mauriac Syndrome

Mauriac syndrome is a rare disorder that can present with the single feature of glycogenic hepatopathy in children and adults with poorly controlled diabetes mellitus. An often underrecognized finding of glycogenic hepatopathy is lactic acidosis and hyperlactatemia. Primary treatment of glycogenic hepatopathy is improved long-term blood glucose control. Resolution of symptoms and hepatomegaly will occur with improvement in hemoglobin A1C. We present here a case of a young adult female presenting to the intensive care unit with Mauriac syndrome. This case demonstratesexacerbationof lactic acidosis in a patient with glycogenic hepatopathy treated for diabetic ketoacidosis with high dose insulin and dextrose.

Endovascular Treatment of Iliac Occlusive Disease: Review and Update

Vascular ◽  
2007 ◽  
Vol 15 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Albeir Y. Mousa ◽  
Robert B. Beauford ◽  
Lucio Flores ◽  
Peter L. Faries ◽  
Prem Patel ◽  
...  
Keyword(s):  
Transluminal Angioplasty ◽  
Occlusive Disease ◽  
Success Rates ◽  
Endovascular Interventions ◽  
Late Failure ◽  
Therapeutic Measures ◽  
Comparison Of Techniques ◽  
Open Versus ◽  
Angioplasty And Stenting

Use of endovascular interventions for arterial occlusive lesions continues to increase. With the evolution of the technology supporting these therapeutic measures, the results of these interventions continue to improve. In general, a comparison of techniques for revascularization of iliac occlusive diseases shows similar initial technical success rates for open versus percutaneous transluminal angioplasty. Angioplasty is often associated with lower periprocedural morbidity and mortality rates. Conversely, surgery frequently provides greater long-term patency, although late failure of percutaneous therapies may occur but still can be treated successfully with reintervention. The perpetual buildup of experience with angioplasty and stenting will eventually characterize its role in the management of occlusive disease. This review outlines the current consensus and applicability of endovascular management of iliac occlusive diseases.

Management of spinal dural arteriovenous malformations

1989 ◽  
Vol 70 (6) ◽  
pp. 832-836 ◽  
Author(s):  
Michael K. Morgan ◽  
W. Richard Marsh
Keyword(s):  
Arteriovenous Malformations ◽  
Primary Treatment ◽  
Endovascular Embolization ◽  
Content Type ◽  
Early Improvement ◽  
Time To Treatment Failure ◽  
Spinal Arteriovenous Malformations ◽  
Progressive Paraparesis ◽  
Dural Avm

✓ Dura-based spinal arteriovenous malformations (AVM's) are being diagnosed with increasing frequency. The optimal management of such lesions remains a topic of discussion. In an effort to guide this discussion, the authors review their experience with 17 cases of spinal dural AVM treated between January, 1984, and July, 1987. All patients presented with a slowly progressive paraparesis. The abnormalities were initially identified on myelography and confirmed by selective spinal angiography. Fourteen patients underwent endovascular embolization as a primary treatment, and a total of 18 embolization procedures were performed. After all but two of these, obliteration was confirmed at angiography. Patients' symptoms improved following 15 or these procedures but early improvement was not sustained in 10 instances; patients were unchanged after two procedures and worse after one. Follow-up angiography was performed at varying intervals after 15 of the 18 procedures, and recanalization of the previously obliterated spinal dural AVM was demonstrated in 13 instances. Eight patients ultimately underwent surgical treatment of their dura-based spinal AVM. No patient suffered deterioration of symptoms following operation. While embolization may allow angiographic obliteration of a spinal dural AVM and early clinical improvement, for the majority of patients these are not sustained. The average time to treatment failure was 5 months. Newer embolization materials will be necessary to effect permanent treatment in many of these patients.

Sign in / Sign up

Export Citation Format

Share Document