scholarly journals Pulmonary arteriovenous malformation (PAVM) embolization: prediction of angiographically-confirmed recanalization according to PAVM Diameter changes on CT

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jihoon Hong ◽  
Sang Yub Lee ◽  
Jung Guen Cha ◽  
Jae-Kwang Lim ◽  
Jongmin Park ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Case Series ◽  
Pulmonary Angiography ◽  
Endovascular Embolization ◽  
Pulmonary Arteriovenous Malformation ◽  
Conventional Angiography ◽  
Receiver Operating Characteristic Curves ◽  
Vein Diameter ◽  
Diameter Reduction

Abstract Background To assess pulmonary arteriovenous malformation (PAVM) recanalization after embolization based on PAVM diameter changes on computed tomography (CT), with pulmonary angiography used as a gold standard. Methods A retrospective review was done of patients from 2008 to 2019 with a PAVM treated with endovascular embolization. The treatment outcome was determined by conventional angiography. Follow-up pulmonary angiography was performed when recanalization was suspected on CT, or embolization of all lesions in multiple PAVM patients could not be completed in a single session. Patients who had no preprocedural or follow-up CT were excluded. Draining vein, feeding artery, and venous sac diameter were measured on CT, and diameter reduction rates were compared with the widely-used, binary 70 % criteria. Results Forty-one patients with 114 PAVMs were treated during the study period. Eight patients with 50 PAVMs met the inclusion criteria. Mean vein, artery, and venous sac diameter reduction rates were as follows: 59.2 ± 9.3 %, 47.5 ± 10.6 %, and 62.6 ± 13.2 %, respectively, in the occluded group and 5.4 ± 19.5 %, 11.3 ± 17.7 %, and 26.8 ± 14.2 %, respectively, in the recanalized group. The area under the receiver operating characteristic curves for PAVM recanalization for the draining vein was 1.00, showing a better result than the artery (0.97) and sac (0.99). Patients showed > 42 % draining vein diameter reduction in the occluded group and < 32 % in the recanalized group. The widely-used 70 % criteria showed low specificity for predicting recanalization (draining vein, 7.3 %; venous sac, 41.7 %) but 100 % sensitivity for both the draining vein and venous sac. Conclusions The widely-used 70 % binary criteria showed limited performance in predicting outcomes in this angiographically-confirmed case series. Further investigations are warranted to establish a strategy for detecting recanalization after PAVM embolization.

Surgical and Endovascular Management of Arteriovenous Malformation: Case Series from a Single Center

Vascular ◽  
2007 ◽  
Vol 15 (3) ◽  
pp. 134-140 ◽  
Author(s):  
Mohamed A. Elsharawy ◽  
Khaled M. Moghazy
Keyword(s):  
Arteriovenous Malformation ◽  
Case Series ◽  
Surgical Excision ◽  
Preoperative Embolization ◽  
Conventional Angiography ◽  
Ethanol Sclerotherapy ◽  
Superselective Embolization ◽  
Endovascular Approach ◽  
A Prospective Study

Management of arteriovenous malformation (AVM) remains a major challenge to vascular surgeons. A multidisciplinary approach was introduced in our hospital to manage these cases from October 2003 to date. This is a report of our experience in their management. A prospective study was done on all patients with symptomatic AVM admitted to our unit between October 2003 and May 2006. All patients had preoperative duplex scanning and magnetic resonance imaging with or without conventional angiography. A multidisciplinary team assessed and treated these cases according to the type of malformation. Thirty-two cases were included in this study, with a mean follow-up of 18.3 months. Of these, 20 cases were predominantly venous and treated with surgical excision ( n = 14) or ethanol sclerotherapy ( n = 6). Twelve cases were predominantly arterial or arteriovenous shunting; 10 were treated with preoperative embolization followed by surgical excision and the remaining 2 with superselective embolization alone. The overall complication rate was high (31%). However, all were minor and settled down conservatively. No recurrence was observed in the early follow-up period. Management of AVM by a surgical and endovascular approach can deliver excellent results, with acceptable morbidity and no recurrence in the early follow-up period.

Postembolotherapy Pulmonary Arteriovenous Malformation Follow-Up

CHEST Journal ◽  
2020 ◽  
Vol 157 (5) ◽  
pp. 1278-1286 ◽  
Author(s):  
Daniel M. DePietro ◽  
Nicole R. Curnes ◽  
Jesse Chittams ◽  
Victor A. Ferrari ◽  
Reed E. Pyeritz ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Pulmonary Arteriovenous Malformation

Vein Diameter on Unenhanced Multidetector CT Predicts Reperfusion of Pulmonary Arteriovenous Malformation after Embolotherapy

2015 ◽  
Vol 26 (8) ◽  
pp. 2723-2729 ◽  
Author(s):  
Delphine Gamondès ◽  
Salim Si-Mohamed ◽  
Vincent Cottin ◽  
Sophie Gonidec ◽  
Loïc Boussel ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Multidetector Ct ◽  
Pulmonary Arteriovenous Malformation ◽  
Vein Diameter

Pulmonary Arteriovenous Malformation Treated with Embolotherapy: Systemic Collateral Supply at Multidetector CT Angiography after 2–20-year Follow-up

Radiology ◽  
2007 ◽  
Vol 242 (1) ◽  
pp. 267-276 ◽  
Author(s):  
Pierre-Yves Brillet ◽  
Philippe Dumont ◽  
Nébil Bouaziz ◽  
Alain Duhamel ◽  
François Laurent ◽  
...  
Keyword(s):  
Arteriovenous Malformation ◽  
Ct Angiography ◽  
Multidetector Ct ◽  
Pulmonary Arteriovenous Malformation ◽  
Multidetector Ct Angiography

Endovascular embolization of a muscular symptomatic arteriovenous malformation with Glubran 2 acrylic glue

Vascular ◽  
2014 ◽  
Vol 23 (4) ◽  
pp. 432-435
Author(s):  
Enrique M San Norberto ◽  
José A Brizuela ◽  
Álvaro Revilla ◽  
James H Taylor ◽  
Carlos Vaquero
Keyword(s):  
Arteriovenous Malformation ◽  
Vastus Lateralis ◽  
Transcatheter Embolization ◽  
Endovascular Embolization ◽  
Deep Fascia ◽  
Vastus Lateralis Muscle ◽  
Clinical Complications ◽  
Glubran 2 ◽  
Acrylic Glue

Objective Few cases of muscle arteriovenous malformations have been reported in literature to date. Case report We report the case of a 32-year-old man presenting a muscle arteriovenous malformation involving the vastus lateralis muscle with recurrent episodes of pain. The patient was treated by transcatheter embolization with Glubran 2 acrylic glue. There were no periprocedural or subsequent clinical complications, the glue resulted in successful selective occlusion and the patient showed resolution of symptoms at the six-months follow-up. Conclusions Endovascular therapy has been shown to be beneficial in patients with high surgical risks and is the treatment of choice for arteriovenous malformation lesions that extend beyond the deep fascia and involve muscle, tendon, and bone. Glubran 2 constitutes a useful tool to attempt embolization of the muscle arteriovenous malformation nidus, with easier handling and promising results.

Delayed hemorrhage from the tissue of an occluded arteriovenous malformation after stereotactic radiosurgery: report of 3 cases

2016 ◽  
Vol 126 (6) ◽  
pp. 1899-1904 ◽  
Author(s):  
Conor Grady ◽  
Omar Tanweer ◽  
David Zagzag ◽  
Jafar J. Jafar ◽  
Paul P. Huang ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Case Series ◽  
Imaging Findings ◽  
Cerebral Arteriovenous Malformations ◽  
Conventional Angiography ◽  
Delayed Hemorrhage ◽  
Negative Findings ◽  
Angiographic Evidence ◽  
Risk Of Hemorrhage

Stereotactic radiosurgery is widely used to treat cerebral arteriovenous malformations (AVMs), with the goal of complete angiographic obliteration. A number of case series have challenged the assumption that absence of residual AVM on follow-up angiograms is consistent with elimination of the risk of hemorrhage. The authors describe 3 cases in which patients who had angiographic evidence of AVM occlusion presented with late hemorrhage in the area of their prior lesions. They compare the radiographic, angiographic, and histological features of these patients with those previously described in the literature.Delayed hemorrhage from the tissue of occluded AVMs has been reported as early as 4 and as late as 11 years after initial stereotactic radiosurgery. In all cases for which data are available, hemorrhage occurred in the area of persistent imaging findings despite negative findings on conventional angiography. The hemorrhagic lesions that were resected demonstrated a number of distinct histological findings.While rare, delayed hemorrhage from the tissue of occluded AVMs may occur from a number of distinct, angiographically occult postirradiation changes. The hemorrhages in the authors' 3 cases were symptomatic and localized. The correlation of histological and imaging findings in delayed hemorrhage from occluded AVMs is an area requiring further investigation.

Sinus skeletonization: a treatment for dural arteriovenous malformation of the tentorial apex

1996 ◽  
Vol 84 (3) ◽  
pp. 514-517 ◽  
Author(s):  
César P. Lucas ◽  
Evandro de Oliveira ◽  
Helder Tedeschi ◽  
Mario Siqueira ◽  
Mario Lourenzi ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Arteriovenous Malformation ◽  
Endovascular Embolization ◽  
Dural Arteriovenous Malformation ◽  
Content Type ◽  
Suboccipital Craniotomy ◽  
First Case ◽  
Transverse Sinuses ◽  
Fine Print

✓ Two cases of dural arteriovenous malformation of the tentorial apex are presented. Both were treated surgically by means of a sinus skeletonization technique. The operative technique included a combined bioccipital and median suboccipital craniotomy in which the posterior third of the superior sagittal and the straight and bilateral transverse sinuses were skeletonized by incising the falx and the tentorium along the sinuses. Endovascular embolization was used prior to the surgical approach in one case. Clinical and angiographic cure was achieved in both patients, with a follow up of 4 years in the first case and 1 year in the second one. The surgical technique is described in detail.

Obliteration of a metameric spinal arteriovenous malformation (Cobb syndrome) using combined endovascular embolization and surgical excision

2012 ◽  
Vol 10 (1) ◽  
pp. 44-49 ◽  
Author(s):  
Clemens M. Schirmer ◽  
Steven W. Hwang ◽  
Ron I. Riesenburger ◽  
In Sup Choi ◽  
Carlos A. David
Keyword(s):  
Arteriovenous Malformation ◽  
Vascular Malformation ◽  
Surgical Excision ◽  
Endovascular Embolization ◽  
Neurological Function ◽  
High Morbidity ◽  
Partial Recovery ◽  
Spinal Vascular Malformation ◽  
Spinal Arteriovenous Malformation

Cobb syndrome represents the concurrent findings of a metameric spinal vascular malformation and a cutaneous vascular malformation within several dermatomes of each other. This rare entity engenders many difficult decisions with respect to appropriate therapeutic management. Historically, surgical excision carried a high morbidity, and conservative management without intervention was preferred. More recently, several cases of endovascular embolization have been reported with good success. The authors describe the case of a 17-year-old boy who presented with a right gluteal angioma and was found to have a spinal arteriovenous malformation. Multiple embolizations failed to prevent neurological deterioration, and the patient eventually became wheelchair dependent. Surgical excision of the malformation led to partial recovery of neurological function, and at the latest follow-up, 52 months postoperatively, the patient was able to ambulate independently. This case demonstrates the successful treatment of a patient with Cobb syndrome with surgical excision after multiple refractory embolizations. A multidisciplinary approach, which balances the patient's current neurological function against the risks and potential gains from any interventional and surgical procedure, is recommended.

scholarly journals Endovascular management of middle cerebral artery aneurysms (single-center case series study)

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Mostafa Mohamed Mostafa Elian ◽  
Ahmed Sayed Ibrahim Issa ◽  
Mohamed Ahmed Ibrahim ◽  
Osama Abd El Wadood Khalil ◽  
Farouk Hassan Youssef
Keyword(s):  
Clinical Outcome ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Case Series ◽  
Flow Diverter ◽  
Thromboembolic Complication ◽  
Conventional Angiography ◽  
Early Results ◽  
Case Series Study

Abstract Background Middle cerebral artery (MCA) aneurysms were usually subjected to treatment by surgery, while endovascular treatment (EVT) was performed only in chosen patients. We assessed the efficacy, safety, and durability in addition to the clinical outcome of EVT when it is regarded as the first-line treatment modality for MCA aneurysms. Results We recruited 30 patients with MCA aneurysms who underwent definitive management from July 2017 to July 2018. All those patients were treated endovascularly; 22 patients (73.3%) presented with subarachnoid hemorrhage, and 8 patients (26.7%) had different presentations, including isolated headaches and seizures. EVT was performed for all patients and required the use of a balloon, stent, or double catheter techniques in 13 cases and flow diverter stents alone in two cases. Clinical outcome was assessed by the modified Rankin Scale (mRS) at 3 months. Angiographic follow-up was done by a conventional angiography at 6 months and after 1 year. EVT was efficiently conducted, leading to an outstanding accomplishment (mRS = 1–2) in 29 patients. However, one patient had a thromboembolic complication, followed by death after severe chest infection that was not related to the procedure. Immediate anatomical results included complete aneurysmal occlusion with the establishment of normal cerebral circulation. Angiographic follow-up revealed 24 unchanged occlusions and 5 cases with recanalization that required further treatment. Conclusion EVT of MCA aneurysms is a viable treatment option with positive outcomes in most cases. Nevertheless, the employment of long-term imaging follow-up is compulsory for validating such early results, often with respect to anatomical and functional stability.

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