Use of a Wire-Directed Microcatheter, without Guiding Catheter or Introducer, to Perform Both Diagnostic and Therapeutic Neuroradiologic Procedures in Neonates and Infants

2002 ◽  
Vol 15 (6) ◽  
pp. 653-660
Author(s):  
G. K. Ricciardi ◽  
F. Granata ◽  
S. Vinci ◽  
A. Biondi ◽  
A. Pitrone ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Posterior Cranial Fossa ◽  
Boston Scientific ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Coated Wire ◽  
Diagnostic Angiography ◽  
Cranial Fossa ◽  
Neonates And Infants ◽  
Guiding Catheter

Performing both diagnostic angiography and endovascular treatments in infants and neonates may be a challenge. The choice of materials represents one of the major difficulties. We present two cases of newborns and one of an infant in which an on-the-wire microcatheter with hydrophilic coating was used without any guiding catheter nor sheath in the management of three different pathologies. A 24 gauge cannula, a 0.014-inch micro-guidewire and a hydrophilic-coated wire-directed microcatheter (Tracker Excel 14, Boston Scientific/Target Therapeutics, Freemont, CA, USA) where the only tools used to perform angiographies and subsequent treatments. One of the patients had a rapidly growing facial haemangioma resistant to medical therapy. One had a posterior cranial fossa pial fistula and another had a vein of Galen malformation.

Abstract TP407: Transvenous Pressure Monitoring Guides Endovascular Treatment of Vein of Galen Malformation

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Daniel Chang ◽  
Miguel D Quintero-Consuegra ◽  
Juan F Toscano ◽  
Robin Babadjouni ◽  
Kelly Danielpour ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Venous Pressure ◽  
Common Femoral Artery ◽  
High Morbidity ◽  
Vein Of Galen ◽  
Continuous Assessment ◽  
Pressure Monitoring ◽  
Vein Of Galen Malformation ◽  
Diagnostic Angiography ◽  
The Difference

Background: Vein of Galen Malformation (VGM) is a complex vascular disorder with high morbidity and mortality. Mainstay management involves staged endovascular embolizations. Determining when to stop an embolization during any single intervention is challenging. If embolization is excessive, it precipitates thrombosis on the VGM, increase in cardiac post-load, and worsening on heart failure, as well as hemorrhages. Conversely, insufficient embolization may be futile. We report the use of transvenous pressure monitoring as an adjuvant for guiding the extent of embolization. Method: Arterial and venous accesses were obtained through the common femoral artery and vein, respectively. After diagnostic angiography, the best working projection was selected in early and late venous phases. A microcatheter was placed at the VG, and an intermediate 5 Fr. catheter was located at the persistent falcine sinus. The microcatheter was used for coil embolization, while the intermediate catheter provided support and was connected for continuous venous pressure monitoring. Continuous arterial pressure monitoring was obtained via an A-line and transduction of a glide catheter located in the carotid artery. Arterial and venous SBP were recorded. Result: Serial angiograms during treatment showed reduction of flow within the VGM. Concomitantly, there was an increase in the A-V-gradient over time (Figure 1). The difference between the A-V SBP went from 36 mmHg at the start of the case to 51 mmHg after the final coil. The average pressure gradient went from 38.3 mmHg in the first quarter to 43.5 mmHg in the last. Conclusion: The continuous assessment of transvenous pressure monitoring during embolization of VGM provides measurable changes that correlate with degree of flow. This quantifiable metric may be used as an adjunct to guide adequate reduction of flow during endovascular treatment of VGM.

Assessment of Cognitive Function Before and After Surgery for Posterior Cranial Fossa Lesions

Skull Base ◽  
2009 ◽  
Vol 19 (03) ◽  
Author(s):  
Shinya Ishimura ◽  
Takayuki Ohira ◽  
Masahito Kobayashi ◽  
Tadashige Kano ◽  
Maaya Orii ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Posterior Cranial Fossa ◽  
Before And After ◽  
Cranial Fossa

Traumatic Epidural Hematomas of the Posterior Cranial Fossa

Skull Base ◽  
2009 ◽  
Vol 19 (S 02) ◽  
Author(s):  
N. Syrmos ◽  
Ch. Iliadis ◽  
J. Marakomichelakis ◽  
G. Gavridakis ◽  
V. Valadakis ◽  
...  
Keyword(s):  
Posterior Cranial Fossa ◽  
Cranial Fossa

A cardiopulmonary bypass strategy to support a patient with vein of Galen malformation

Perfusion ◽  
2021 ◽  
pp. 026765912110015
Author(s):  
Alex Robertson ◽  
Nagarajan Muthialu ◽  
Mike Broadhead
Keyword(s):  
Cardiopulmonary Bypass ◽  
Surgical Repair ◽  
Circulatory Arrest ◽  
Ductus Arteriosus ◽  
Venous Drainage ◽  
Deep Hypothermic Circulatory Arrest ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Neurological Sequelae ◽  
Ph Stat

We present a dissection of the patent ductus arteriosus and pulmonary artery for surgical repair utilising cardiopulmonary bypass in the setting of vein of Galen malformation. Several strategies were employed to attenuate the cerebral shunt including pH-stat, high cardiac index, restrictive venous drainage, continuous ventilation and deep hypothermic circulatory arrest. The patient recovered from surgery with no apparent neurological sequelae.

Successful Surgical and Anesthetic Management of Vein of Galen Aneurysm in a Neonate in Congestive Heart Failure

Neurosurgery ◽  
1988 ◽  
Vol 22 (5) ◽  
pp. 908-910 ◽  
Author(s):  
Jane Matjasko ◽  
Walker Robinson ◽  
Daniel Eudaily
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Cardiac Failure ◽  
Growth And Development ◽  
Anesthetic Management ◽  
Vascular Supply ◽  
Vein Of Galen ◽  
Vein Of Galen Malformation ◽  
Vein Of Galen Aneurysm

Abstract A 12-day-old infant in intractable cardiac failure due to a vein of Galen malformation was treated successfully with serial ligation of the majority of the vessels feeding the malformation. Despite some residual vascular supply to the malformation, the congestive heart failure has disappeared and growth and development have been normal over a 3-year follow-up period.

scholarly journals THE VEINS OF THE POSTERIOR CRANIAL FOSSA: AN ANGIOGRAPHIC STUDY UNDER PATHOLOGIC CONDITIONS

1970 ◽  
Vol 110 (1) ◽  
pp. 39-49 ◽  
Author(s):  
F. GALLIGIONI ◽  
R. BERNARDI ◽  
M. PELLONE ◽  
G. IRACI
Keyword(s):  
Posterior Cranial Fossa ◽  
Angiographic Study ◽  
Cranial Fossa
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