Abstract 1122‐000080: Remote Learning for Neuroendovascular Procedures During the COVID‐19 Pandemic

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
John Vargas Urbina ◽  
Rodolfo Rodriguez‐Varela ◽  
Giancarlo Saal‐Zapata ◽  
John Vargas‐Urbina ◽  
Aaron Rodriguez‐Calienes
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Endovascular Procedures ◽  
Vascular Lesions ◽  
Live Streaming ◽  
Google Glass ◽  
Technical Problems ◽  
Online Platforms ◽  
Subdural Hematomas ◽  
Remote Learning

Introduction : Telemedicine coupled with teleproctoring have been a novel practice in the last months given the restrictive mobilization orders worldwide due to the COVID‐19 pandemic, generating the impossibility to travel and learn new techniques or bring a proctor to perform procedures on‐site. Previous papers have reported the benefits of remote proctoring for endovascular procedures using online platforms, whereas others proposed the use of more simple platforms and applications for telemedicine such as Zoom Ò , WhatsApp Ò or Google Glass Ò . Our study aimed to describe our experience in the implementation of remote learning for endovascular treatment of vascular lesions using a multicamera system streamed by a web‐based platform. Methods : Endovascular treatment of aneurysms, arteriovenous malformations, and chronic subdural hematomas were streamed through a multicamera system installed in the angiosuite and shared via Zoom® platform. Four main cameras projected the angiography monitors, the operator’s hands and the overview of the room. Results : Eleven cases were performed. Aneurysms, arteriovenous malformations and chronic subdural hematomas were treated by endovascular means. Preoperative angiographic setup, intraoperative endovascular technique and postoperative management were discussed during the live streaming. No technical problems were reported. Conclusions : Remote learning with online platforms is nowadays an important tool but not a substitute to hands‐on learning for endovascular procedures. We recommend its implementation during the COVID‐19 pandemic as a temporary substitute especially for trainees who do not have access to advanced endovascular interventions.

scholarly journals Overview of Neo-Vascular Lesions after Delivery or Miscarriage

2021 ◽  
Vol 10 (5) ◽  
pp. 1084
Author(s):  
Yuji Shiina
Keyword(s):  
Arteriovenous Malformations ◽  
Uterine Artery ◽  
Spontaneous Regression ◽  
Vascular Diseases ◽  
Vascular Lesions ◽  
Artery Pseudoaneurysm ◽  
Retained Products Of Conception ◽  
Products Of Conception ◽  
Uterine Artery Pseudoaneurysm ◽  
Retained Products

The concept of intrauterine neo-vascular lesions after pregnancy, initially called placental polyps, has changed gradually. Now, based on diagnostic imaging, such lesions are defined as retained products of conception (RPOC) with vascularization. The lesions appear after delivery or miscarriage, and they are accompanied by frequent abundant vascularization in the myometrium attached to the remnant. Many of these vascular lesions have been reported to resolve spontaneously within a few months. Acquired arteriovenous malformations (AVMs) must be considered in the differential diagnosis of RPOC with vascularization. AVMs are errors of morphogenesis. The lesions start to be constructed at the time of placenta formation. These lesions do not show spontaneous regression. Although these two lesions are recognized as neo-vascular lesions, neo-vascular lesions on imaging may represent conditions other than these two lesions (e.g., peritrophoblastic flow, uterine artery pseudoaneurysm, and villous-derived malignancies). Detecting vasculature at the placenta–myometrium interface and classifying vascular diseases according to hemodynamics in the remnant would facilitate the development of specific treatments.

The endovascular treatment of arteriovenous malformations

2001 ◽  
Vol 1 (1) ◽  
pp. 64-82
Author(s):  
Christopher Ian MacKay ◽  
Cameron G. McDougall
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations

Characteristics of Brain Arteriovenous Malformations Presenting with Seizures without Acute or Remote Hemorrhage

2011 ◽  
Vol 24 (6) ◽  
pp. 886-888 ◽  
Author(s):  
P. Jiang ◽  
X. Lv ◽  
Z. Wu ◽  
Y. Li ◽  
C. Jiang ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Posterior Fossa ◽  
Arteriovenous Malformations ◽  
Venous Drainage ◽  
Brain Arteriovenous Malformations ◽  
Male Sex

We report on the predictors of seizure presention in unruptured brain arteriovenous malformations (AVMs). Between 1999 and 2008, 302 consecutive patients with AVMs were referred to our institution for endovascular treatment. Seventy-four patients (24.5%) experienced seizures without hemorrhage before treatment. We tested for statistical associations between angioarchitectural characteristics and seizure presentation. When we compared the 74 patients with seizures without hemorrhage with the 228 patients who did not experience seizures initially (total of 302 patients), male sex, cortical AVM location, AVM size of more than 3 cm, superficial venous drainage and presence of varices in the venous drainage were statistically associated with seizures (P=0.016, P=0.002, P=0.022, P=0.005, and P=0.022, respectively). Posterior fossa and deep locations and coexisting aneurysms were statistically associated with no seizures. The angioarchitectural characteristics of AVM associated with seizure presentation include male sex, cortical AVM location, AVM size of more than 3 cm, superficial venous drainage and presence of varices in the venous drainage.

scholarly journals A proposed grading system for endovascular treatment of cerebral arteriovenous malformations: Buffalo score

2015 ◽  
Vol 6 (1) ◽  
pp. 3 ◽  
Author(s):  
EladI Levy ◽  
TravisM Dumont ◽  
Peter Kan ◽  
KennethV Snyder ◽  
LNelson Hopkins ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Grading System ◽  
Cerebral Arteriovenous Malformations

Endovascular Advances for Brain Arteriovenous Malformations

Neurosurgery ◽  
2014 ◽  
Vol 74 (suppl_1) ◽  
pp. S74-S82 ◽  
Author(s):  
R. Webster Crowley ◽  
Andrew F. Ducruet ◽  
Cameron G. McDougall ◽  
Felipe C. Albuquerque
Keyword(s):  
Endovascular Treatment ◽  
Surgical Resection ◽  
Arteriovenous Malformations ◽  
Treatment Options ◽  
Brain Arteriovenous Malformations ◽  
Short Period ◽  
Cerebral Avms ◽  
Brain Avms ◽  
The Brain ◽  
The Way

Abstract Arteriovenous malformations (AVMs) of the brain represent unique challenges for treating physicians. Although these lesions have traditionally been treated with surgical resection alone, advancements in endovascular and radiosurgical therapies have greatly expanded the treatment options for patients harboring brain AVMs. Perhaps no subspecialty within neurosurgery has seen as many advancements over a relatively short period of time as the endovascular field. A number of these endovascular innovations have been designed primarily for cerebral AVMs, and even those advancements that are not particular to AVMs have resulted in substantial changes to the way cerebral AVMs are treated. These advancements have enabled the embolization of cerebral AVMs to be performed either as a stand-alone treatment, or in conjunction with surgery or radiosurgery. Perhaps nothing has impacted the treatment of brain AVMs as substantially as the development of liquid embolics, most notably Onyx and n-butyl cyanoacrylate. However, of near-equal impact has been the innovations seen in the catheters that help deliver the liquid embolics to the AVMs. These developments include flow-directed catheters, balloon-tipped catheters, detachable-tipped catheters, and distal access catheters. This article aims to review some of the more substantial advancements in the endovascular treatment of brain AVMs and to discuss the literature surrounding the expanding indications for endovascular treatment of these lesions.

scholarly journals Hemorrhagic Complications after Endovascular Treatment of Cerebral Arteriovenous Malformations

2014 ◽  
Vol 35 (5) ◽  
pp. 978-983 ◽  
Author(s):  
H. Baharvahdat ◽  
R. Blanc ◽  
R. Termechi ◽  
S. Pistocchi ◽  
B. Bartolini ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Cerebral Arteriovenous Malformations ◽  
Hemorrhagic Complications

The endovascular management of splenic artery aneurysms and pseudoaneurysms

Vascular ◽  
2011 ◽  
Vol 19 (5) ◽  
pp. 257-261 ◽  
Author(s):  
Jia Xin ◽  
Liu Xiao-ping ◽  
Guo Wei ◽  
Xiong Jiang ◽  
Zhang Hong-peng ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Splenic Artery ◽  
Endovascular Procedures ◽  
Endovascular Management ◽  
Total Procedure Time ◽  
The Mean ◽  
Postembolization Syndrome ◽  
Mid Term Results ◽  
Total Procedure

The purpose of this study was to evaluate outcomes of the endovascular treatment of splenic artery aneurysms (SAAs) and pseudoaneurysms (SAPAs). From April 2003 to December 2009, 12 patients (mean age 46.8 years, range 29–58) with SAAs ( n = 9) or SAPAs ( n = 3) underwent endovascular treatment. Four patients were asymptomatic and three had ruptured aneurysms. Lesions were in the proximal splenic artery ( n = 3), intermediate splenic artery ( n = 3) and distal splenic artery ( n = 6). Endovascular procedures included embolization by sac packing ( n = 5), sandwich occlusion of the splenic artery ( n = 4) or stent graft deployment ( n = 3). Computed tomography (CT) was done before the operation, 3 and 12 months after the operation, then yearly. Endovascular treatment was successful at the first attempt in all 12 (100%) patients, with complete angiographic exclusion of the aneurysm at the end of the operation. The mean amount of contrast medium used was 165 mL (range 100–230), and the mean total procedure time was 92 minutes (range 55–160). No major complications occurred. Postoperational CT scans showed splenic multisegmental infarcts in eight patients (66.7%, 8/12) and among them postembolization syndrome developed in six patients, manifesting as abdominal pain and fever. The mean follow-up was 32 months (range 9–51). No patient demonstrated gross evidence of aneurysm sac growth, and no significant decrease in aneurysm sac size postintervention was noted on follow-up. The endovascular management of SAAs and SAPAs is safe and effective and may induce less mortality than open surgery. Regardless of the etiology, endovascular treatment can provide excellent mid-term results.

scholarly journals A Technical Note

2013 ◽  
Vol 19 (1) ◽  
pp. 27-34 ◽  
Author(s):  
V.M. Pereira ◽  
A. Marcos-Gonzalez ◽  
I. Radovanovic ◽  
P. Bijlenga ◽  
A.P. Narata ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Young Patient ◽  
Arteriovenous Malformations ◽  
Technical Note ◽  
Cerebral Arteriovenous Malformations ◽  
Arterial Access ◽  
Therapeutic Method ◽  
Endovascular Approach ◽  
Ruptured Avm ◽  
Transvenous Approach

Ruptured cerebral arteriovenous malformations (AVMs) usually require treatment to avoid re-bleeding. Depending on the angioarchitecture and center strategy, the treatment can be surgical, endovascular, radiosurgical or combined methods. The classic endovascular approach is transarterial, but sometimes it is not always applicable. The transvenous approach has been described as an alternative for the endovascular treatment of small AVMs when arterial access or another therapeutic method is not possible. This approach can be considered when the nidus is small and if there is a single draining vein. We present a technical note on a transvenous approach for the treatment of a ruptured AVM in a young patient.

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