Congenital Vascular Malformations in the Hand and Forearm

2001 ◽  
Vol 8 (5) ◽  
pp. 484-494 ◽  
Author(s):  
Constantinos T. Sofocleous ◽  
Robert J. Rosen ◽  
Keith Raskin ◽  
Bram Fioole ◽  
Dirk-John Hofstee
Keyword(s):  
Vascular Malformations ◽  
Retrospective Chart Review ◽  
Percutaneous Treatment ◽  
Low Flow ◽  
Vascular Lesions ◽  
Technical Success ◽  
Intention To Treat ◽  
Single Center Experience ◽  
Long Term Follow Up

Purpose: To review a single-center experience in the management of symptomatic congenital vascular malformations of the hand and forearm with special attention to embolotherapy. Methods: A retrospective chart review was performed to identify patients with vascular malformations referred for arteriography and possible intervention between 1983 and 1998. Arteriography and venography were performed in all patients to differentiate between true high-flow arteriovenous malformations (AVM) and low-flow primary venous malformations (PVM). The clinical and radiological data, procedural results, and follow-up data were retrieved and reviewed. Results: In a 15-year period, 39 patients (22 men; mean age 22.5 years, range 1–51) had symptomatic vascular lesions diagnosed in the forearm and hand: 21 AVMs, 17 PVMs, and one complex lesion with both AVM and PVM. Thirty-four (87%) lesions were treated with immediate technical success achieved in 31 (91%) cases; 5 (13%) lesions were not amenable to percutaneous treatment. There were no major complications, but 3 embolized AVMs had significant residual flow (81.6% technical success on intention to treat basis). Long-term follow-up ranging to 5 years was available in 26 of the 34 treated patients; the mean symptom-free period was 30 months for the AVM patients and 30.5 months for the PVM group, with an average of 1.5 and 1.2 embolization procedures, respectively. Conclusions: Vascular malformations of the hand and forearm are extremely rare lesions that demand a multidisciplinary approach for optimal diagnosis and management. Microembolotherapy with or without surgery has offered the highest level of safety and success to date.

scholarly journals Surgical treatment and outcome of cerebral cavernomas – a 10 years’ experience

2014 ◽  
Vol 21 (4) ◽  
pp. 395-405
Author(s):  
A. Giovani ◽  
Aurelia Sandu ◽  
Angela Neacsu ◽  
R.M. Gorgan
Keyword(s):  
Vascular Malformations ◽  
Clinical Status ◽  
Low Flow ◽  
Vascular Lesions ◽  
Term Outcome ◽  
Cavernous Malformations ◽  
Long Term Outcome ◽  
Long Term Follow Up

Abstract Cavernous malformations (cavernomas) are congenital low flow angiographic occult vascular lesions with a high tencency to bleeding. The prevalence of cerebral cavernous vascular malformations is estimated to be 0.4% to 0.9%.2,7 CMs in deep locations, including the brainstem, thalamus, and basal ganglia, account for 9% to 35% of all malformations in the brain. We performed a retrospective 10 years study on 130 operated cerebral cavernomas and discussed the clinical status at presentation, the choice and timing of the surgical approach and the short and longterm follow up. The 130 operated cases were divided into a supratentorial 102 (78.46%) group and an infratantorial group 28 (21.53%). The average age at presentation was 43,62 years old (17-76) and there was no sex predominance, male/female = 1,44 (77/53). Only in 14 cases (10.76%) we could find multiple cavernomas which had relatives with multiple cavrnomas, but the familial inheritance was not studied, and only the symptomatic lesion was resected. We divided the outcome results reporting for agroup with superficial respectively profound lesions. The long term follow up for the patients in the profound lesions group showed that 31/37 (83,78%) of patients had a mRS between 0 and 2, and the rest had a poor long term outcome. After surgery there was no clinical deterioration in the superficial lesions group and 22 patients from those who presented in mRS 2 showed neurological improvement on long term follow up, meaning that 82,79% of patients had a 0 or 1 mRS. Microsurgery is the treatment of choice in symptomatic brain cavernomas, total resection being the only curative treatment, capable to prevent further bleeding and to offer an efficient control of seizures.

Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms

2014 ◽  
Vol 121 (5) ◽  
pp. 1093-1101 ◽  
Author(s):  
Christopher R. Durst ◽  
Robert M. Starke ◽  
John R. Gaughen ◽  
Scott Geraghty ◽  
K. Derek Kreitel ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Outcomes ◽  
Technical Success ◽  
Parent Vessel ◽  
Technical Success Rate ◽  
Single Center Experience ◽  
Long Term Follow Up ◽  
Coil Migration

Object The endovascular treatment of wide-necked aneurysms can be technically challenging due to distal coil migration or impingement of the parent vessel. In this paper, the authors illustrate an alternative method for the treatment of wide-necked intracranial aneurysms using a dual microcatheter technique. Methods The authors' first 100 consecutive patients who underwent coil embolization of a wide-necked aneurysm using a dual microcatheter technique are reported. With this technique, 2 microcatheters are used to introduce coils into the aneurysm. The coils are deployed either sequentially or concurrently to form a stable construct and prevent coil herniation or migration. Angiographic and clinical outcomes are reported. Results The technical success rate of the dual microcatheter technique is 91% with a morbidity and mortality of 1% and 2%, respectively. Clinical outcomes are excellent with 93% of patients demonstrating a modified Rankin Scale score of 0–2 at long-term follow-up regardless of their score at presentation. Retreatment rates are 18%. Conclusions The dual microcatheter technique may be a safe and efficacious first line of treatment for widenecked aneurysms.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

scholarly journals Spontaneously Resolved Macrocystic Lymphatic Malformations: Predictive Variables and Outcomes

2017 ◽  
Vol 25 (1) ◽  
pp. 27-31 ◽  
Author(s):  
Michael J. Phang ◽  
Douglas J. Courtemanche ◽  
Marija Bucevska ◽  
Claudia Malic ◽  
Jugpal S. Arneja
Keyword(s):  
Respiratory Tract ◽  
Median Time ◽  
Vascular Malformations ◽  
Neck Region ◽  
Retrospective Chart Review ◽  
Spontaneous Resolution ◽  
Low Flow ◽  
Upper Respiratory Tract ◽  
Lymphatic Malformations ◽  
Upper Respiratory

Introduction: Lymphatic malformations are benign, low-flow vascular malformations that typically present at or near birth. Due to morbidity associated with operative treatment, nonoperative treatment with injection of sclerosant has become the mainstay of therapy. Over the past 15 years, several patients at our centre with macrocystic (>2 cm cyst size) lymphatic malformations have seen their lesions resolve spontaneously while awaiting treatment. In this study, we review features of these patients that may contribute to spontaneous resolution. Method: A retrospective chart review was conducted from our Vascular Anomalies Clinic database (1999-2014) of all macrocystic lymphatic malformations; characteristics of patients with spontaneous resolution were reviewed. Results: Of 61 patients with macrocystic lymphatic malformations, 7 cases (11.5%; 4 females, 3 males) resolved spontaneously. Median age at malformation appearance was 2 years (range: 0-6.5 years), with median age at resolution of 4 years (range: 10 months-7 years). Median time from appearance to resolution was 24 months (range: 3-43 months), with a median follow-up time of 4 years (range: 1-15 years). All but 1 case was associated with local or upper respiratory tract infection antecedent to resolution. Six of the 7 lesions were located in the neck. Conclusion: Among the cases reviewed, there was a common theme of upper respiratory tract or local infection antecedent to spontaneous lesion resolution. Compared to the literature, our proportion of malformations presenting after birth and the proportion of malformations presenting in the neck region were higher than those of other series. Although side effects associated with treatment are generally mild and/or rare, risks related to sclerotherapy and the accompanying requirement for general anesthesia in pediatric populations nevertheless exist. As the median time from lesion appearance to resolution was 24 months, it may be reasonable to observe these malformations for up to 24 months before proceeding with treatment if the lesion does not impair function and disfigurement is not considerable, particularly if the lesion presents after birth and/or is located in the neck region.

Long term follow-up of patients with prolactinomas and outcome of dopamine agonist withdrawal: a single center experience

Pituitary ◽  
2011 ◽  
Vol 15 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Panagiotis Anagnostis ◽  
Fotini Adamidou ◽  
Stergios A. Polyzos ◽  
Zoe Efstathiadou ◽  
Eleni Karathanassi ◽  
...  
Keyword(s):  
Dopamine Agonist ◽  
Single Center ◽  
Single Center Experience ◽  
Long Term Follow Up

The quality of life in extracorporeal life support survivors: single-center experience of a long-term follow-up

2018 ◽  
Vol 35 (2) ◽  
pp. 227-235 ◽  
Author(s):  
Valentina Di Leo ◽  
Paolo Biban ◽  
Federico Mercolini ◽  
Francesco Martinolli ◽  
Andrea Pettenazzo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Single Center ◽  
Single Center Experience ◽  
Long Term Follow Up
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