Initial experience with the Scepter Mini dual-lumen balloon for transophthalmic artery embolization of anterior cranial fossa dural arteriovenous fistulae

2020 ◽  
Vol 12 (11) ◽  
pp. 1132-1136 ◽  
Author(s):  
Benjamin Pulli ◽  
Eric S Sussman ◽  
Vera Mayercik ◽  
Gary K Steinberg ◽  
Huy M Do ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Vision Loss ◽  
Anterior Cranial Fossa ◽  
Significant Advance ◽  
Initial Experience ◽  
Artery Embolization ◽  
Arteriovenous Fistulae ◽  
Distal Catheter ◽  
Embolic Agents ◽  
Cranial Fossa

BackgroundPrecise delivery of liquid embolic agents (LEAs) remains a challenge in the endovascular treatment of dural arteriovenous fistulae (dAVFs) and cerebral arteriovenous malformations (cAVMs). Despite significant advances in the past decade, LEA reflux and catheter navigability remain shortcomings of current endovascular technology, particularly in small and tortuous arteries. The Scepter Mini dual-lumen balloon microcatheter aims to address these issues by decreasing the distal catheter profile (1.6 French) while allowing for a small (2.2 mm diameter) balloon at its tip.MethodsWe report our initial experience with the Scepter Mini in two patients with anterior cranial fossa dAVFs that were treated with transophthalmic artery embolization.ResultsIn both patients, the Scepter Mini catheter was able to be safely advanced into the distal ophthalmic artery close to the fistula site, and several centimeters past the origins of the central retinal and posterior ciliary arteries. A single Onyx injection without any reflux resulted in angiographic cure of the dAVF in both cases, and neither patient suffered any vision loss.ConclusionsThese initial experiences suggest that the Scepter Mini represents a significant advance in the endovascular treatment of dAVFs and cAVMs and will allow for safer and more efficacious delivery of LEAs into smaller and more distal arteries while diminishing the risk of LEA reflux.

scholarly journals Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Shuhei Kawabata ◽  
Hajime Nakamura ◽  
Takeo Nishida ◽  
Masatoshi Takagaki ◽  
Nobuyuki Izutsu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Anterior Cranial Fossa ◽  
Maxillary Artery ◽  
Flow Reduction ◽  
Cranial Fossa ◽  
Embolic Materials

ABSTRACT Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, high blood flow from the internal maxillary artery (IMA) often impedes penetration of embolic materials into the shunt pouch. Therefore, reducing blood flow from the IMA before embolization can increase the success rate. In the present case, to reduce blood flow from branches of the IMA, we inserted surgical gauze infiltrated with xylocaine and epinephrine into bilateral nasal cavities. Using this method, we achieved curative TAE with minimal damage to the nasal mucosa. Transnasal flow reduction is an easy, effective and minimally invasive method. This method should be considered in the endovascular treatment of ACF–dAVF, especially in patients with high blood flow from theIMA.

Endovascular treatment of anterior cranial fossa dural arteriovenous fistula: a multicenter series

2020 ◽  
Author(s):  
Guilherme Dabus ◽  
Peter Kan ◽  
Carlos Diaz ◽  
Boris Pabon ◽  
Juan Andres-Mejia ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Anterior Cranial Fossa ◽  
Cranial Fossa

Anterior Cranial Fossa Dural Arteriovenous Fistulae – Angioarchitecture and Intervention

2020 ◽  
Author(s):  
Karthik Kulanthaivelu ◽  
Hima Pendharkar ◽  
Chandrajit Prasad ◽  
Arun Kumar Gupta ◽  
Arvinda Hanumanthapura Ramalingaiah ◽  
...  
Keyword(s):  
Anterior Cranial Fossa ◽  
Arteriovenous Fistulae ◽  
Cranial Fossa

scholarly journals Initial experience with HydroPearl microspheres for uterine artery embolization for the treatment of symptomatic uterine fibroids

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Matthew A. Patetta ◽  
Ari J. Isaacson ◽  
Jessica K. Stewart
Keyword(s):  
Uterine Artery Embolization ◽  
Uterine Artery ◽  
Uterine Fibroids ◽  
Invasive Procedure ◽  
Embolic Agent ◽  
Initial Experience ◽  
Success Rates ◽  
Artery Embolization ◽  
Embolic Agents

Abstract Background Uterine Artery Embolization (UAE) is a minimally invasive procedure used to treat symptomatic uterine fibroids. The HydroPearl Microsphere (Terumo Interventional Systems) is an embolic agent approved for UAE and other embolization procedures. The purpose of this article is to describe our initial experience with HydroPearl for UAE in patients with symptomatic uterine fibroids. Twenty-one patients who underwent UAE using HydroPearl Microspheres at a single institution from May 1, 2018 to December 31, 2019 were included in the study. The electronic medical record (EMR) was reviewed for documentation of short- and long-term complications, as well as improvements in menorrhagia and bulk-type symptoms. We also describe unique attributes of the HydroPearl Microsphere that should be considered when utilizing this embolization particle for UAE. Results Of the 21 patients, 18 had a 3-month or later post-procedure follow-up documented in the EMR and were included in the analysis. The average time between the UAE procedure and the most recent clinical note was 145 days. Sixteen patients reported symptoms of menorrhagia and 13 reported bulk symptoms prior to the UAE procedure. On follow-up, 13/16 patients (81%) and 12/13 patients (92%) experienced improvement in menorrhagia and bulk symptoms, respectively. The only recorded complication was amenorrhea in 4 patients (22%) who had an average age of 51 years. Conclusions Several characteristics of HydroPearl Microsphere may prove helpful when considering these embolic particles for use in UAE. Our initial experience with this embolic agent suggest that the reatment response for menorrhagia and bulk symptoms are largely similar to success rates reported in the literature for other embolic agents. Larger studies are needed to evaluate the safety and efficacy of this embolic particle for this indication.

Endonasal Endoscopic Approach for a Psammomatous Juvenile Active Ossifying Fibroma: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Nickalus R Khan ◽  
Turki Elarjani ◽  
Jolie A Crespo ◽  
Zoukaa Sargi ◽  
Jacques J Morcos
Keyword(s):  
Vision Loss ◽  
Large Mass ◽  
Endoscopic Approach ◽  
Anterior Cranial Fossa ◽  
Ossifying Fibroma ◽  
Operative Techniques ◽  
Mri Scans ◽  
Rare Lesion ◽  
Cranial Fossa ◽  
Magnetic Resonance Imaging Mri

Abstract We present the case of an 18-yr-old female with 4 mo of progressive vision loss in the left eye. She underwent a computed tomography (CT) and magnetic resonance imaging (MRI), which revealed a large mass in the sphenoid sinus, sella, and anterior cranial fossa. This mass was T1 isointense, with heterogenous enhancement noted on T1 with gadolinium sequences. The mass was found to have calcifications and cystic portions on T2-weighted MRI scans and CT-based imaging. She underwent an endonasal endoscopic approach for resection of the mass. The tumor was found to be bloody, with islands of bone nests within the dura mater of the anterior cranial fossa. The patient improved postoperatively. The pathological diagnosis was found to be the psammomatoid variant of juvenile active ossifying fibroma (JAOF). We present the neuroimaging, anatomic nuances,1 and operative techniques used in this case. We also review the disease background of this rare lesion of the anterior skull base.2-4  The patient gave informed consent for the procedure and verbal consent for the publication of this article.

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