scholarly journals Selective and Superselective Angiography of Pediatric Moyamoya Disease Angioarchitecture: The Anterior Circulation

2014 ◽  
Vol 20 (4) ◽  
pp. 391-402 ◽  
Author(s):  
Gerasimos Baltsavias ◽  
Anton Valavanis ◽  
Venko Filipce ◽  
Nadia Khan
Keyword(s):  
Moyamoya Disease ◽  
Anterior Circulation ◽  
Feeding Vessels ◽  
Occlusive Lesion ◽  
Superselective Angiography ◽  
Anterior Choroidal ◽  
Ethmoidal Arteries ◽  
Lateral Branches ◽  
First Time ◽  
Choroidal Artery

The angioarchitecture of the so-called moyamoya vessels in children has not been explicitly analyzed. We aimed to investigate the precise anatomy of the vascular anastomotic networks in patients with childhood moyamoya disease. Six children diagnosed with moyamoya disease for the first time underwent an angiographic investigation with selective and superselective injections. We recorded the arterial branches feeding the moyamoya anastomotic networks, their connections and the recipient vessels. Depending on the level of the steno-occlusive lesion, the feeding vessels included the medial striate arteries, the perforators of the choroidal segment of the carotid, the uncal artery, the medial and lateral branches of the intraventricular segment of the anterior choroidal artery, perforators of the communicating segment, the superior hypophyseal arteries, the prechiasmal branches of the ophthalmic artery, the ethmoidal arteries and the dural branches of the cavernous carotid. Through connections, which are described, the recipient vessels were the lateral striate arteries and the middle cerebral, the medial striate arteries and the anterior cerebral, medullary arteries around the ventricular system, anterior temporal branches of the middle cerebral, orbitofrontal and frontopolar branches of the anterior cerebral, as well as other cortical branches of the anterior and middle cerebral territories. The use of high quality selective and superselective angiography enabled us to clearly demonstrate for the first time aspects of the microangiographic anatomy of the moyamoya anastomotic network previously only vaguely or incompletely described.

scholarly journals Selective and Superselective Angiography of Pediatric Moyamoya Disease Angioarchitecture in the Posterior Circulation

2014 ◽  
Vol 20 (4) ◽  
pp. 403-412 ◽  
Author(s):  
Gerasimos Baltsavias ◽  
Nadia Khan ◽  
Venko Filipce ◽  
Anton Valavanis
Keyword(s):  
Moyamoya Disease ◽  
Posterior Cerebral Artery ◽  
Posterior Circulation ◽  
Anterior Circulation ◽  
Feeding Vessels ◽  
Occlusive Lesion ◽  
Superselective Angiography ◽  
Anterior Choroidal ◽  
Premamillary Artery ◽  
Choroidal Artery

The anastomotic network of the posterior circulation in children with moyamoya disease has not been analyzed. We aimed to investigate the angiographic anatomy of this unique vascular network in patients with childhood moyamoya disease. Selective and superselective injections of the posterior circulation were performed in six children with newly diagnosed moyamoya disease. The arterial branches feeding the moyamoya anastomotic network, their connections and the recipient vessels were demonstrated. Depending on the level of the steno-occlusive lesion, the feeding vessels were the thalamoperforators, the posterior choroidals, the splenic artery, parietoccipital artery, other cortical posterior cerebral artery (PCA) branches, the dural branch of the PCA, the premamillary artery and other posterior communicating artery perforators. Through connections, which are described, the recipient vessels were the striate and medullary arteries, other thalamic arteries with or without medullary extensions, the pericallosal artery, medial parietoccipital cortical branches of the PCA and the anterior choroidal artery. High quality selective and superselective angiography helped in demonstrating the angiographic anatomy of the moyamoya posterior anastomotic network previously either vaguely or incompletely described, as well as connections within the posterior circulation but also its relevance as a collateral to the anterior circulation.

scholarly journals Disappearance of a ruptured distal anterior choroidal artery aneurysm following surgical revascularization for moyamoya disease with hemorrhagic onset

Nosotchu ◽  
2012 ◽  
Vol 34 (3) ◽  
pp. 187-192 ◽  
Author(s):  
Keisuke Toyoda ◽  
Shuji fukuda ◽  
Shunsuke Ishizaka ◽  
Tomonori Takeshita ◽  
Kentaro Hayashi ◽  
...  
Keyword(s):  
Moyamoya Disease ◽  
Artery Aneurysm ◽  
Anterior Choroidal Artery ◽  
Surgical Revascularization ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract T P18: Incidence and Management of Intracranial Wire Perforation During Acute Stroke Endovascular Therapy

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Deepak Gulati ◽  
Amin Aghaebrahim, ◽  
Amer Malik ◽  
Andrew Ducruet ◽  
Brian Jankowitz ◽  
...  
Keyword(s):  
Acute Stroke ◽  
Posterior Circulation ◽  
Preventive Strategies ◽  
Anterior Choroidal Artery ◽  
Balloon Inflation ◽  
Anterior Circulation ◽  
Endovascular Thrombectomy ◽  
Intracranial Stenting ◽  
Anterior Choroidal ◽  
Choroidal Artery

BACKGROUND: Wire perforation during endovascular thrombectomy for acute stroke is a rare but devastating complication. Understanding the incidence and mechanism of this adverse event may further identify preventive strategies and improvements in management during perforation. METHODS: Retrospective review of a prospectively maintained database of acute stroke interventions at our institute identified 1035 patients. Of these, 46 patients were noted to have contrast extravastion during the procedure concerning for wire perforation (4%). RESULTS: A majority of the cases involved the anterior circulation (76%). Sites of perforation included: ICA (12), MCA (23), ophthalmic (1), anterior choroidal (2), PCA (4), PICA (1), SCA (1) and vertebral artery (2). Successful hemostasis was achieved with onyx embolization (39%), coil embolization (13%), onyx/coil combined embolization (5%), microcatheter occlusion (2%) and balloon inflation (7%). Thirty one percentage of the cases occurred during intracranial stenting or angioplasty. Despite high rates of mortality (72%), rapid recognition of extravasation and hemostasis led to good outcomes in 9% of patient. CONCLUSION: Intra-procedural wire perforation with leakage of contrast is associated with catheterization of small caliber vessels such as distal MCA branches (M3), anterior choroidal artery and diminutive posterior circulation vessels as well as intracranial angioplasty/stenting. Devastating outcomes can potentially be averted with appropriate hemostatic control.

Distal Anterior Choroidal Artery Aneurysm in a Patient with Moyamoya Disease: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 48 (1) ◽  
pp. 222-225 ◽  
Author(s):  
Jung-Kil Lee ◽  
Je-Hyuk Lee ◽  
Soo-Han Kim ◽  
Min-Cheol Lee
Keyword(s):  
Case Report ◽  
Moyamoya Disease ◽  
Artery Aneurysm ◽  
Anterior Choroidal Artery ◽  
Disease Case ◽  
Anterior Choroidal ◽  
Choroidal Artery

scholarly journals Patency of anterior circulation branch vessels after Pipeline embolization: longer-term results from 82 aneurysm cases

2017 ◽  
Vol 126 (4) ◽  
pp. 1064-1069 ◽  
Author(s):  
Leonardo Rangel-Castilla ◽  
Stephan A. Munich ◽  
Naser Jaleel ◽  
Marshall C. Cress ◽  
Chandan Krishna ◽  
...  
Keyword(s):  
Arterial Occlusion ◽  
Side Branch ◽  
Terminal Branch ◽  
Anterior Choroidal Artery ◽  
Anterior Circulation ◽  
Branch Vessel ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Ophthalmic Arteries

OBJECTIVE The Pipeline Embolization Device (PED) has become increasingly used for the treatment of intracranial aneurysms. Given its high metal surface area coverage, there is concern for the patency of branch vessels that become covered by the device. Limited data exist regarding the patency of branch vessels adjacent to aneurysms that are covered by PEDs. The authors assessed the rate of intracranial internal carotid artery, anterior circulation branch vessel patency following PED placement at their institution. METHODS The authors retrospectively reviewed the records of 82 patients who underwent PED treatment between 2009 and 2014 and in whom the PED was identified to cover branch vessels. Patency of the anterior cerebral, posterior communicating, anterior choroidal, and ophthalmic arteries was evaluated using digital subtraction angiography preoperatively and postoperatively after PED deployment and at longer-term follow-up. RESULTS Of the 127 arterial branches covered by PEDs, there were no immediate postoperative occlusions. At angiographic follow-up (mean 10 months, range 3–34.7 months), arterial side branches were occluded in 13 (15.8%) of 82 aneurysm cases and included 2 anterior cerebral arteries, 8 ophthalmic arteries, and 3 posterior communicating arteries. No cases of anterior choroidal artery occlusion were observed. Patients with branch occlusion did not experience any neurological symptoms. CONCLUSIONS In this large series, the longer-term rate of radiographic side branch arterial occlusion after coverage by a flow diverter was 15.8%. Terminal branch vessels, such as the anterior choroidal artery, remained patent in this series. The authors' series suggests that branch vessel occlusions are clinically silent and should not deter aneurysm treatment with flow diversion.

Distal Anterior Choroidal Artery Aneurysm in a Patient with Moyamoya Disease: Case Report

Neurosurgery ◽  
2001 ◽  
Vol 48 (1) ◽  
pp. 222-225 ◽  
Author(s):  
Jung-Kil Lee ◽  
Je-Hyuk Lee ◽  
Soo-Han Kim ◽  
Min-Cheol Lee
Keyword(s):  
Case Report ◽  
Moyamoya Disease ◽  
Artery Aneurysm ◽  
Anterior Choroidal Artery ◽  
Disease Case ◽  
Anterior Choroidal ◽  
Choroidal Artery

Endoscopic treatment of distal choroidal artery aneurysm

2011 ◽  
Vol 114 (1) ◽  
pp. 116-119 ◽  
Author(s):  
Marc Lévêque ◽  
Nancy McLaughlin ◽  
Mathieu Laroche ◽  
Michel W. Bojanowski
Keyword(s):  
Moyamoya Disease ◽  
Artery Aneurysm ◽  
Lateral Wall ◽  
Parent Artery ◽  
Resonance Imaging ◽  
Left Lateral Ventricle ◽  
Anterior Choroidal ◽  
Neurologically Intact ◽  
Choroidal Artery ◽  
Deep Location

Distal choroidal artery aneurysms stemming from the lateral wall of the ventricles are rare and are mostly associated with moyamoya disease. The treatment of these aneurysms is difficult because of their deep location. The authors report the case of a 50-year-old woman followed for moyamoya disease presenting with 2 intraventricular hemorrhages. Cerebral angiography showed an aneurysm located on the left distal choroidal artery. Magnetic resonance imaging also demonstrated that the lesion protruded from the lateral wall of the trigone of the left lateral ventricle. Using MR imaging–guided stereotactic localization, the aneurysm was accurately reached endoscopically and successfully resected from the parent artery. The patient was discharged neurologically intact. To the best of the authors' knowledge, this is the first report of a successfully endoscopically treated distal anterior choroidal artery aneurysm. Endoscopic surgery may be added to the armamentarium of procedures used to treat intraventricular aneurysms.

scholarly journals Endovascular Embolization of Distal Anterior Choroidal Artery Aneurysms Associated with Moyamoya Disease

2010 ◽  
Vol 16 (4) ◽  
pp. 433-441 ◽  
Author(s):  
S. Yang ◽  
J.-L. Yu ◽  
H.-L. Wang ◽  
B. Wang ◽  
Q. Luo
Keyword(s):  
Prognostic Factors ◽  
Literature Review ◽  
Moyamoya Disease ◽  
Lateral Ventricle ◽  
Endovascular Embolization ◽  
Parent Artery ◽  
Anterior Choroidal Artery ◽  
Temporal Horn ◽  
Anterior Choroidal ◽  
Choroidal Artery

We evaluated the feasibility of endovascular embolization for the management of distal anterior choroidal artery (AChA) aneurysms associated with moyamoya disease and performed a literature review to summarize their clinical features and treatment. We describe two cases of moyamoya disease-associated distal AChA aneurysms treated by endovascular embolization. In both cases, a good outcome was observed. We performed a MEDLINE (1980–2010) search which identified 13 similar cases. Our analysis of the clinical data from these 15 cases led us to conclude that (i) endovascular embolization is an effective and feasible treatment for distal AChA aneurysms associated with moyamoya disease; (ii) aneurysm location and the preservation of the parent artery are two major prognostic factors for moyamoya disease-associated distal AChA aneurysms subjected to craniotomy or endovascular therapy; (iii) the parent artery should be preserved when the aneurysm is located in the temporal horn of the lateral ventricle, but sacrificed when it is located in the trigone of the lateral ventricle.

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