Intracranial Arteriovenous Malformation: Cinematic Rendering with                     Digital Subtraction Angiography

There are various methods for measuring an affected vascular size during embolization or percutaneous transluminal angioplasty (PTA). Metallic balls, electrodes, grids, coins on the skin were simple and useful in this sense, but not stable and exact for measuring. A 0.014 “or 0.016” microguide wire with 5 gold markers in the tip is newly developed and used clinically (a scaler guide). One marker measures 1 mm in length. There is a distance of 4 mm between two neighboring markers. A microcatheter is navigated using a standard microguide wire into the vessels of the lesion. Bilateral digital subtraction angiography (DSA) is performed after exchange of a microguide wire with a scaler guide. Magnification ratio between distance measured by DSA and real distance from markers is calculated. Thereafter, the size of the vessels will be measured. With this method, the size of vessels was measured in patients with aneurysm or arteriovenous malformation or stenotic lesion. Selection of coils or PTA balloons could be made easily and effectively. Interventions were more safely performed with this new scaler guide.

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Clinical and Radiation Diagnosisof Renal Arteriovenous Malformation

Medical Visualization ◽

10.24835/1607-0763-2017-3-53-61 ◽

2017 ◽

pp. 53-61

Author(s):

A. N. Askerova

Keyword(s):

Arteriovenous Malformation ◽

Digital Subtraction Angiography ◽

Arteriovenous Malformations ◽

Multidetector Ct ◽

Accurate Information ◽

Digital Subtraction ◽

Ct Scanner ◽

Medical Systems ◽

Iodinated Contrast ◽

Renal Arteriovenous Malformation

Purpose:to analyze the results of preoperative diagnosis and treatment of patients with renal arteriovenous malformation and compare them with the literature data.Materials and methods.5 patients with renal arteriovenous malformations were examined for the period from 2014 to2016 in the FSBI "A.V. Vishnevsky Institute of Surgery» MH RF, where simultaneously there are clinical departments of urology and vascular surgery, 4 of them were treated. All patients were female. The mean age was 31.8 ± 6.7 years (24–41 years). Ultrasound was done to all the patients in B-mode followed by a duplex scan using an abdominal 2–4 MHz convex. MDCT was performed in 4 patients out of 5. Patients underwent multiphase examination on a multidetector CT-scanner Philips Brilliance iCT-256 and Brilliance CT-64 (Philips Medical Systems (Cleveland) with the 120 kV and 100 kV protocols and an intravenous injection of the iodinated contrast agent. Digital subtraction angiography was performed in 3 patients.Results.One-sided lesion occurred in four cases (3 of them (60%) right-sided and 1 (20%) left-sided), in one patient (20%) arteriovenous malformation was bilateral As a result of the analysis of our own material and literature data, the diagnostic criteria of renal arteriovenous malformations according to ultrasound, MDCT and digital subtraction angiography were studied in detail. The results of the examinations of 5 patients with demonstration of ultrasound, MDCT and angiographic images are presented with the visualization of the characteristic features of renal AVM. In addition, the treatment options for such patients with the possibility of preserving the kidney are described.Conclusion.Duplex scanning is an effective method of diagnosis and postoperative follow-up of patients with renal arteriovenous malformations. Preoperative computed tomography and selective digital subtraction angiography provide accurate information about the renal angioarchitectonics and AV-shunts for choosing the treatment tactics and planning the surgical intervention.

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Detection of Predictors of Hemorrhage in Patients with Cerebral Arteriovenous Malformation by Digital Subtraction Angiography

Bangladesh Journal of Neurosurgery ◽

10.3329/bjns.v8i2.42349 ◽

2019 ◽

Vol 8 (2) ◽

pp. 87-92

Author(s):

Fazlul Haque ◽

Shariful Islam ◽

Monzurul Haque ◽

Shafiul Alam ◽

Raziul Haque

Keyword(s):

Arteriovenous Malformation ◽

Digital Subtraction Angiography ◽

Venous Drainage ◽

High Flow ◽

Cerebral Arteriovenous Malformation ◽

P Value ◽

Digital Subtraction ◽

College Hospital ◽

Multiple Imaging ◽

Arterial Feeder

Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vessels in which arteries flow directly into veins without capillaries. The main cause of death in patients with cerebral AVM is intraparenchymal hemorrhage. There are multiple imaging tools that can detect the predictors of hemorrhage in cerebralarteriovenous malformation. But nowadays digital subtraction angiography (DSA) is playing a wonderful role to detect these predictors. Objectives: To detect the common predicting factors of hemorrhage from in brain by DSA. Methodology:This observational cross-sectional study was carried out in the department of Neurosurgery, Dhaka Medical College Hospital and study period was from October, 2014 to March, 2016. 76 patients of hemorrhagic stroke with clinical and radiological (CT scan) suspicion of ruptured cerebral AVM were selected by non-probability purposive sampling technique. After that enrolled patients were scrutinized according to selection criteria. Finally selected 50 patients who underwent DSA and were positive for AVM were included in this study. All the included patients’ demographic, clinical and DSA profile were recorded in pre-structured data collection sheet. All the data were compiled, edited and plotted in tabular and figure forms. Data analysis was done by chi-square test. P value was determined significant when it was <0.05. Results: In angiographic presentation, maximum cases were found deep seated (72%), small sized (<3 cm) (70%), having compact type of nidus (58%), having superficial arterial feeder (62%), having high flow draining vein (70%), having deep venous drainage (56%) and single draining vein (78%). Associated aneurysm and venous ectasia were 12% and 4% respectively. The statistically significant predictors were deep location (P=0.036) and superficial arterial feeder (P=0.03) between male and female subjects. Conclusion: Our results showed that small sized, deep-seated Cerebral arteriovenous malformation, having high flow draining vein, having deep venous drainage and single number of draining vein are the possible causes of hemorrhage. Lesions that have associated aneurysms have a risk of bleeding. Bang. J Neurosurgery 2019; 8(2): 87-92

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Peritherapeutic quantitative flow analysis of arteriovenous malformation on digital subtraction angiography

Journal of Vascular Surgery ◽

10.1016/j.jvs.2012.02.041 ◽

2012 ◽

Vol 56 (3) ◽

pp. 812-815 ◽

Cited By ~ 14

Author(s):

Tzung-Chi Huang ◽

Tung-Hsin Wu ◽

Chung-Jung Lin ◽

Greta S.P. Mok ◽

Wan-Yuo Guo

Keyword(s):

Arteriovenous Malformation ◽

Digital Subtraction Angiography ◽

Flow Analysis ◽

Digital Subtraction ◽

Quantitative Flow

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Association of intracranial arteriovenous malformation embolization with more rapid rate of perfusion in the peri-nidal region on color-coded quantitative digital subtraction angiography

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2019-015776 ◽

2020 ◽

Vol 12 (9) ◽

pp. 902-905 ◽

Cited By ~ 2

Author(s):

Sphoorti Shellikeri ◽

Harrison Bai ◽

Randolph M Setser ◽

Robert W Hurst ◽

Anne Marie Cahill

Keyword(s):

Digital Subtraction Angiography ◽

Internal Carotid ◽

Brain Parenchyma ◽

Digital Subtraction ◽

Intracranial Arteriovenous Malformations ◽

Anterior Circulation ◽

Intracranial Arteriovenous Malformation ◽

Time To Peak ◽

Procedural Complications ◽

Rapid Perfusion

BackgroundHemodynamic alterations post-embolization of intracranial arteriovenous malformations (AVMs) may cause delayed edema/hemorrhage in brain parenchyma adjacent to the lesion.ObjectiveTo quantify and compare cerebral perfusion changes in the peri-AVM territory pre- and post-embolization using color-coded quantitative digital subtraction angiography (q-DSA).MethodsPediatric intracranial AVM embolization procedures performed over a 5 year period were included. DSA images of all patients were retrospectively assessed using syngo iFlow. Regions of interest (ROI) were selected on anteroposterior and lateral q-DSA views: three in the peri-AVM region; two in parenchyma distant from the AVM. Time-to-peak (TTP) contrast enhancement of ROIs and ∆TTP (TTP at the selected ROI minus TTP at either the ipsilateral internal carotid/vertebral artery) were measured.Result19 pediatric patients with 19 AVMs (9 males/10 females, mean age 12 years) underwent intracranial AVM embolization: 15/19 AVMs were supplied by the anterior circulation and 4/19 by the posterior circulation. Blood flow was significantly slower post-embolization in the draining vein (19/19) (p<0.01), and the venous sinus outflow (17/19) (p<0.01), by mean difference of 2.01±1.31 s and 1.74±2.04 s. There was significantly increased peri-AVM parenchymal perfusion post-embolization (∆TTP=2.20±0.48 s) compared with pre-embolization (∆TTP=2.52±0.42 s), by an average ∆TTP of 0.33±0.53 s (p=0.014). In contrast, there was no perfusion difference (∆TTP=0.03±0.20 s, p=0.8) between pre- and post-embolization in the distant parenchyma. The size of the AVM was not correlated with change in peri-nidal parenchymal perfusion (r=−0.136, p=0.579).ConclusionThis study demonstrates more rapid perfusion in the peri-nidal brain parenchyma post-embolization of the AVM, which supports the theory that increased perfusion in normal tissue surrounding the AVM after embolization may underlie some post-procedural complications.

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