scholarly journals De novo intracranial arteriovenous malformation development after endovascular treatment for a pial arteriovenous fistula in capillary malformation-arteriovenous malformation syndrome

2020 ◽  
pp. 159101992094051
Author(s):  
Bikei Ryu ◽  
Shinsuke Sato ◽  
Tatsuki Mochizuki ◽  
Tatsuya Inoue ◽  
Yoshikazu Okada ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Fistula ◽  
De Novo ◽  
High Flow ◽  
Intracranial Arteriovenous Malformation ◽  
Capillary Malformation ◽  
Systemic Disorder ◽  
Pial Arteriovenous Fistula ◽  
The Brain

Capillary malformation-arteriovenous malformation (CM-AVM) syndrome is a newly described entity characterized by autosomal dominantly inherited multifocal capillary malformations caused by RASA1 mutations (CM-AVM1) or EPHB4 mutations (CM-AVM2). Concurrent high-flow vascular anomalies in the brain are often present in the form of intracranial AVM or arteriovenous fistula (AVF). These high-flow lesions are often identified at or soon after birth because of the characteristic unique capillary malformations or a systemic disorder due to a high-flow shunt, such as respiratory distress or heart failure. However, de novo intracranial AVMs have not been reported in patients with CM-AVM syndrome. Herein, we report the case of a six-year-old boy with CM-AVM1 who had been treated for an intracranial pial arteriovenous fistula approximately five years previously, in whom a de novo intracranial AVM was identified on a follow-up angiographic study. To the best of our knowledge, this report is the first to document a de novo intracranial AVM in a patient with CM-AVM. We recommend careful neuroimaging follow-up even if initial neuroimaging screening is negative because of the risk of de novo AVM development.

Republished: Rete mirabile associated with pial arteriovenous fistula: imaging features with literature review

2017 ◽  
Vol 9 (9) ◽  
pp. e36-e36 ◽  
Author(s):  
Prabath Kumar Mondel ◽  
Rashmi Saraf ◽  
Uday S Limaye
Keyword(s):  
Arteriovenous Fistula ◽  
Treatment Options ◽  
Imaging Features ◽  
Rete Mirabile ◽  
Bilateral Carotid ◽  
Normal Human ◽  
Pial Arteriovenous Fistula ◽  
Neurologically Normal ◽  
The Brain

A rete mirabile is a vascular network of intercommunicating small arteries or arterioles that replace the definitive adult artery supplying the brain. It supplies the brain in lower mammals but is not seen in normal human embryological development. A 26-year-old man presented with worsening tinnitus that was interfering with his sleep. On CT and digital subtraction angiography he was found to have a temporal lobe pial arteriovenous fistula with bilateral carotid and vertebral rete mirabile. The patient was offered open surgical and endovascular treatment options for pial arteriovenous fistula but he refused both and opted for conservative medical management. At 6-month follow-up he continued to have pulsatile tinnitus but was otherwise neurologically normal. We present the first described association of rete mirabile with pial arteriovenous fistula and discuss its clinical presentation and imaging features, with a review of the literature for bilateral carotid and vertebral rete mirabile.

scholarly journals Single Hole High Flow Arteriovenous Fistula

2002 ◽  
Vol 8 (1) ◽  
pp. 55-60 ◽  
Author(s):  
C. Campos ◽  
R. Piske ◽  
J. Nunes ◽  
S.B. Soares ◽  
J.A. Castro ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Fatal Outcome ◽  
High Flow ◽  
Total Occlusion ◽  
Single Hole ◽  
Therapeutic Guidelines ◽  
Venous Ectasia ◽  
Pial Arteriovenous Fistula ◽  
Glue Injection ◽  
The Right

A high flow pial arteriovenous fistula in a twenty-years-old girl is described. The arteriovenous communication corresponds to a single hole fistula on the right rolandic area, with a giant venous ectasia. The patient presented seizures and left hemiparesis as symptoms. The fistula was embolized with glue obtaining total occlusion of the shunt. Hypotension was induced and valsalva manoeuver was done during the glue injection to reduce the flow into the fistula, however 26 hours after the procedure the patient bled resulting in a fatal outcome. The purpose of this paper is discuss the presentation of Rendu-Osler-Weber (ROW) in children and the therapeutic guidelines.

De Novo Intracranial Pial Arteriovenous Fistula After Craniotomy

2010 ◽  
Vol 20 (4) ◽  
pp. 277-279 ◽  
Author(s):  
Yoshitaka Kubo ◽  
Kuniaki Ogasawara ◽  
Hiroshi Kashimura ◽  
Yasunari Otawara ◽  
Shunsuke Kakino ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
De Novo ◽  
Pial Arteriovenous Fistula

Dual Pathologies: Pial Arteriovenous Fistula in Combination with an Arteriovenous Malformation

2020 ◽  
Vol 81 (02) ◽  
pp. 185-187
Author(s):  
Gianpaolo Jannelli ◽  
Holger Joswig ◽  
Gianmarco Bernava ◽  
Torstein R. Meling ◽  
Philippe Bijlenga
Keyword(s):  
Arteriovenous Malformation ◽  
Arteriovenous Fistula ◽  
Operating Room ◽  
Preoperative Planning ◽  
Structural Characteristics ◽  
Sigmoid Sinus ◽  
Direct Connection ◽  
Digital Subtraction ◽  
Hybrid Operating Room ◽  
Pial Arteriovenous Fistula

Abstract Background A pial arteriovenous fistula (PAVF) is a rare neurovascular pathology consisting of a direct connection between one or more arterial feeders and a single venous channel. A PAVF was previously considered a subtype of an arteriovenous malformation (AVM). In the current literature these are distinguished as two independent entities with different clinical, physiopathologic, and structural characteristics. We report a case of a surgically treated 37-year-old woman with an extremely rare combination of an unruptured PAVF and AVM. Patient The AVM was mainly supplied by feeders of the middle cerebral artery and drained into the sigmoid sinus via an abnormally dilated and tortuous vein. Following its resection, intraoperative digital subtraction angiography (DSA) in the hybrid operating room revealed the presence of a PAVF that had not been noted during the preoperative planning. Hence the PAVF was completely disconnected as confirmed by DSA again. Conclusion This is the second reported case of an AVM-associated PAVF. Without the intraoperative DSA in the hybrid operating room, this unusual complex cerebrovascular entity would likely have been missed.

Successful management of an intracranial arteriovenous malformation by conventional irradiation

1985 ◽  
Vol 63 (2) ◽  
pp. 193-195 ◽  
Author(s):  
Francesco Tognetti ◽  
Alvaro Andreoli ◽  
Anna Cuscini ◽  
Claudio Testa
Keyword(s):  
Radiation Therapy ◽  
Arteriovenous Malformation ◽  
Successful Management ◽  
Intracranial Arteriovenous Malformation ◽  
Content Type ◽  
Conventional Radiation ◽  
Complete Obliteration ◽  
Conventional Radiation Therapy ◽  
Fine Print

✓ The reduction of an intracranial arteriovenous malformation (AVM) by conventional radiation therapy is described in a patient who refused surgery. The 2-year follow-up angiogram documented nearly complete obliteration of the nidus of the AVM, accompanied by progressive narrowing of the arteries supplying the lesion. The scanty literature dealing with this form of treatment is summarized.

Intraoperative Gutter Leaks That Merit Our Attention

2017 ◽  
Vol 51 (8) ◽  
pp. 555-561 ◽  
Author(s):  
Adam Tanious ◽  
Mathew Wooster ◽  
Marcelo Giarelli ◽  
Paul A. Armstrong ◽  
Martin R. Back ◽  
...  
Keyword(s):  
De Novo ◽  
Computed Tomographic Angiography ◽  
High Flow ◽  
High Rate ◽  
Low Flow ◽  
Stent Grafts ◽  
Index Procedure ◽  
Computed Tomographic ◽  
Tomographic Angiography

Introduction: The natural history and potential morbidity of gutter endoleaks are unclear. We present our experience with intraoperative gutter endoleaks and strategies to determine which of these require intervention. Methods: This is a retrospective review of all patients treated with parallel stent grafts from January 2010 to September 2015. We reviewed all operative records and intraoperative angiograms as well as all postoperative imaging and secondary interventions. All gutter leaks were classified as low-flow/nonsac-enhancing gutter endoleaks or high-flow/sac-enhancing gutter endoleaks. Adjunctive interventions to manage the gutter leaks were noted, as were all subsequent interventions for gutter leak and endoleak management. Results: Seventy-eight patients had 144 parallel stents placed over a 5-year period with an average of 1.8 stents per patient. Twenty-eight patients (36%) had gutter endoleaks diagnosed intraoperatively. Seventeen patients had adjunctive procedures to reduce gutter leaks prior to leaving the operating room (OR). Patients selected for treatment had gutters filling early during completion angiography and/or contrast enhancement of the aneurysm sac. Twenty-two patients (28%) left the OR with low-flow/delayed/nonsac-enhancing gutter endoleaks. At 30 days, a total of 6 persistent gutter endoleaks were diagnosed on computed tomographic angiography. This gives a 73% rate of resolution for low-flow/nonaneurysm sac-enhancing endoleaks. There were 2 de novo endoleaks not detected at the index procedure diagnosed at 6-month follow-up. Of the 8 total postoperative endoleaks, 5 required additional intervention with a 100% success rate. Multivariate analysis revealed that the only significant predictor of having a postoperative endoleak is leaving the OR with an endoleak. Conclusions: Intraoperative treatment of gutter endoleaks has an acceptable rate of resolution. It does have a high rate of converting high-flow endoleaks to low-flow endoleaks. Low-flow/nonsac-enhancing gutter endoleaks have a high rate of spontaneous resolution. Intraoperative gutter endoleaks are not predictive of future aneurysm sac growth.

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