scholarly journals Endovascular Embolization of Posttraumatic High-Flow Priapism: Uncommon Arteriovenous Fistula of the Corpus Cavernosum

2021 ◽  
Author(s):  
Maarten J. Otten ◽  
Lotte Zuur ◽  
Jasper Florie ◽  
Bart van Bezooijen
Keyword(s):  
Arteriovenous Fistula ◽  
Corpus Cavernosum ◽  
Arterial Embolization ◽  
Endovascular Embolization ◽  
High Flow ◽  
High Rate ◽  
Embolic Agent ◽  
Selective Embolization ◽  
Case Presentation

Abstract Background priapism is a persistent penile erection lasting more than four hours without sexual arousal or stimulation. Non-ischemic high-flow priapism is an uncommon finding. Case presentation: we report on a high-flow priapism, an uncommon arteriovenous fistula of the corpus cavernosum after a straddle trauma which was successfully treated by super selective trans-arterial embolization using a temporary embolic agent. At follow up no recurrent episodes of priapism occurred without symptoms of erectile dysfunction or other complications. Conclusion Super selective embolization has a high rate of technical success with preservation of erectile function in this case without complications.

Treatment of dural arteriovenous fistula using ethylene vinyl alcohol (Onyx) arterial embolization as the primary modality: short-term results

2007 ◽  
Vol 107 (6) ◽  
pp. 1120-1125 ◽  
Author(s):  
Andrew P. Carlson ◽  
Christopher L. Taylor ◽  
Howard Yonas
Keyword(s):  
Arteriovenous Fistula ◽  
Vinyl Alcohol ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Arterial Embolization ◽  
Primary Treatment ◽  
Embolic Agent ◽  
Ethylene Vinyl Alcohol ◽  
Treatment Agent

Object A dural arteriovenous fistula (DAVF) typically involves meningeal feeding arteries and can cause clinical symptoms ranging from tinnitus to rupture of draining cortical or parenchymal veins. Surgical treatment may be technically demanding. Ethylene vinyl alcohol (Onyx, ev3 Neurovascular) has several properties that make it potentially useful as a primary treatment agent for DAVF. Onyx is expected to be a permanent embolic agent. It should have a decreased risk of catheter retention when compared with other permanent embolic materials. Methods The authors report a series of six patients with symptomatic DAVF who were treated initially with transarterial Onyx embolization and other endovascular techniques. Results Five patients had complete occlusion of their DAVF noted on the follow-up angiogram obtained between 2 and 4 months. One patient had residual filling via a small arterial branch that was stable on follow-up angiography. None of the patients had worsening of neurological function. One case was complicated by a retained catheter fragment. Conclusions Transarterial Onyx embolization and other endovascular methods can angiographically obliterate DAVF. In some cases, embolization allowed occlusion of multiple arterial feeding arteries from a single arterial injection. Technically, the embolization was optimized when a microcatheter position immediately adjacent to the point(s) of fistulization was achieved.

scholarly journals Selective arterial embolization for a high-flow priapism following perineal trauma in a young gymnast

2018 ◽  
Vol 90 (3) ◽  
pp. 218-219
Author(s):  
Grazia Bianchi ◽  
Camilla Sachs ◽  
Irene Campo ◽  
Giovanni Liguori ◽  
Carlo Trombetta
Keyword(s):  
Pediatric Patients ◽  
Corpus Cavernosum ◽  
Arterial Embolization ◽  
Rare Condition ◽  
High Flow ◽  
Perineal Trauma ◽  
Internal Pudendal Artery ◽  
Selective Embolization ◽  
Selective Arterial Embolization ◽  
The Right

Introduction. High-flow priapism is a rare condition in children, usually due to a perineal trauma. Materials and methods. We present a case of traumatic highflow priapism investigated by Doppler ultrasound and managed by angiography and selective embolization of a branch of the internal pudendal artery. Results. A 13-year-old gymnast underwent perineal trauma during training and developed a high-flow priapism. The first ultrasound (immediately after the trauma) showed the presence of an inhomogeneous area of 3 x 2 cm associated with an anechoic vascularized area (pseudoaneurysm) in the right corpus cavernosum. On the left side there was a similar finding, but of smaller size. After 3 weeks the pseudoaneurysm on the left was completely obliterated while the right one was still present. Angiography and superselective catheterization of a branch of the left pudendal artery and its embolization with microspheres and with metal microcoils were performed. After the procedure, ultrasound showed that the right pseudoaneurysm was completely obliterated and there were no more branches reaching it. The cavernous arteries were both pervious. Conclusions. Selective arterial embolization is a safe treatment that can also be used in pediatric patients.

Eight-year follow-up after palliative embolization of a neonatal intracranial dural arteriovenous fistula with high-output heart failure: management strategies for symptomatic fistula growth and bilateral femoral occlusions in pediatric patients

2010 ◽  
Vol 6 (6) ◽  
pp. 553-558 ◽  
Author(s):  
Adam S. Reig ◽  
Scott D. Simon ◽  
Wallace W. Neblett ◽  
Robert A. Mericle
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Cardiac Failure ◽  
Dural Arteriovenous Fistula ◽  
Management Strategies ◽  
Endovascular Embolization ◽  
Embolic Agent ◽  
Ethylene Vinyl Alcohol ◽  
High Output

The authors report the 8-year follow-up of a patient previously described in the literature who originally presented in high-output cardiac failure secondary to a complex neonatal intracranial dural arteriovenous fistula (DAVF). The earlier case report described palliative treatment with a combination of extracorporeal membrane oxygenation (ECMO) and endovascular embolization for life-threatening high-output cardiac failure secondary to a DAVF. Access was obtained using the ECMO cannula, and embolization was performed while the patient was connected to the ECMO machine. The patient made an excellent recovery following partial embolization of the fistula, but then presented again 7 years later with worsening headaches secondary to significant growth of the known residual portion of the fistula identified on CT angiography. The child also developed bilateral femoral artery (FA) occlusions secondary to multiple previous FA punctures. To achieve complete obliteration of the remaining fistula, the patient required a retroperitoneal approach to the iliac artery and percutaneous puncture of the internal jugular vein. Embolization was performed with a combination of platinum coils and ethylene vinyl alcohol copolymer liquid embolic agent. There were no complications, and the child remains neurologically normal, with no signs of permanent cardiovascular sequelae. In this case report, the authors discuss the long-term management of AVFs treated by endovascular strategies early in life. After neonatal access, sometimes the FAs occlude, requiring more invasive access strategies. The authors also discuss the follow-up method, intervals, and threshold for further treatment for these lesions, and present a review of the literature.

scholarly journals Successful treatment of acquired uterine arterial venous malformation using N-butyl-2-cyanoacrylate under balloon occlusion

2014 ◽  
Vol 3 (8) ◽  
pp. 204798161454591
Author(s):  
Reiko Woodhams ◽  
Go Ogasawara ◽  
Kenichiro Ishida ◽  
Kaoru Fujii ◽  
Takuro Yamane ◽  
...  
Keyword(s):  
Uterine Artery ◽  
Venous Malformation ◽  
Arterial Embolization ◽  
Balloon Occlusion ◽  
High Flow ◽  
Embolic Agent ◽  
Complete Occlusion ◽  
Occlusion Balloon ◽  
Multiple Feeding ◽  
Diffuse Distribution

We present two cases of acquired uterine arterial venous malformation (AVM) which was diagnosed because of massive genital bleeding successfully treated with transcatheter arterial embolization (TAE), using N-butyl-2-cyanoacrylate (NBCA) under balloon occlusion. Balloon occlusion at the uterine artery was performed in both patients for diffuse distribution of NBCA in multiple feeding branches, as well as to the pseudoaneurysm, and for the prevention of NBCA reflux. In one of our patients, balloon occlusion of the draining vein was simultaneously performed to prevent NBCA migration through accompanying high-flow arteriovenous fistula (AVF). Doppler ultrasound at 6 months of both patients documented persistent complete occlusion of AVM. Complete and safe obliteration of acquired uterine AVM was accomplished using NBCA as embolic agent, under balloon occlusion at the communicating vessels of acquired uterine AVM.

Extramedullary Plasmacytoma of The Frontal Sinus: A Case Report

FACE ◽  
2021 ◽  
pp. 273250162110536
Author(s):  
Joshua Harrison ◽  
Samantha Marley ◽  
Shawhin Shahriari ◽  
Christian Bowers ◽  
Anil Shetty
Keyword(s):  
Frontal Sinus ◽  
Surgical Excision ◽  
Extramedullary Plasmacytoma ◽  
High Rate ◽  
Solitary Plasmacytoma ◽  
Case Presentation ◽  
Long Term Follow Up ◽  
History Of

We report a rare case of an extramedullary plasmacytoma (EMP) in the frontal sinus with an indolent clinical presentation. Although a history of trauma was absent, the initial diagnosis was a mucocele, based on the radiological findings. Upon surgical excision, the patient was found to have an EMP. EMP, a form of solitary plasmacytoma, has a significantly high rate of conversion to multiple myeloma. This mandates long-term follow-up, even after successful radiotherapy and/or resection. While radiation therapy is generally considered a first line treatment for EMP, surgical intervention may provide optimal treatment in complicated cases. This case presentation highlights the prognosis of patients diagnosed with EMP.

scholarly journals Pseudoaneurysm with arteriovenous fistula of the prostate after pelvic trauma: Ultrasound imaging

2016 ◽  
Vol 88 (4) ◽  
pp. 317 ◽  
Author(s):  
Andrea B. Galosi ◽  
Camilla Capretti ◽  
Luca Leone ◽  
Marco Tiroli ◽  
Daniele Cantoro ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Color Doppler ◽  
Pelvic Trauma ◽  
Selective Embolization ◽  
Distal Branch ◽  
Anechoic Area ◽  
Post Traumatic ◽  
Anterior Prostate ◽  
Recurrent Hematuria

Pseudoaneurysm (PA) associated with an arteriovenous fistula (AVF) of the internal pudendal artery branches are very uncommon. We report a case of post-traumatic PA with AVF connected to Santorini plexus. Diagnosis was made with trans-rectal ultrasound (TRUS) after recurrent hematuria. TRUS reported a 1.7 × 1.4 × 1.5 cm anechoic area, on anterior prostate apex close to Santorini plexus. The use of color Doppler in this area revealed high flow velocity that was indicative for AVF. The feeding artery was a distal branch of the left pudenda artery. After selective embolization was observed complete occlusion of the feeding branches and disappearance of PA with AVF. Prostate PA with concomitant symptomatic AVF detected with TRUS has not yet described in literature after pelvic trauma and represents complex diagnostic challenges. This case report suggests that the use of TURS and color Doppler can provide an important diagnostic and follow-up to address the clinical suspicion of occult vascular injuries using a noninvasive approach.

scholarly journals The Efficacy and Safety of Transcatheter Arterial Embolization to Treat Renal Hemorrhage after Percutaneous Nephrolithotomy

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Nan Du ◽  
Jing-Qin Ma ◽  
Jian-Jun Luo ◽  
Qing-Xin Liu ◽  
Zi-Han Zhang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Conservative Treatment ◽  
Percutaneous Nephrolithotomy ◽  
Transcatheter Arterial Embolization ◽  
Univariate Analysis ◽  
Arterial Embolization ◽  
Endovascular Embolization ◽  
Severe Bleeding ◽  
Renal Hemorrhage

Purpose. The aim of this study was to evaluate the safety and efficacy of transcatheter arterial embolization (TAE) in patients with renal hemorrhage after percutaneous nephrolithotomy (PCNL) and evaluate the risk factors that may result in severe bleeding requiring TAE. Methods. We retrospectively reviewed 121 patients with post-PCNL renal hemorrhage. Thirty-two patients receiving endovascular embolization were compared with 89 patients only receiving conservative treatment. The demographic and clinical data were recorded and compared between the two groups. The values of estimated glomerular filtration rate (eGFR) and serum creatinine (SCr) were recorded preoperatively, postoperatively, and at last follow-up and analyzed to evaluate the safety and efficiency of TAE. Results. The successful hemostasis rate of conservative therapy was 73.6% (89/121) and that of TAE was 100% (32/32). SCr and eGFR were not significantly different before PCNL and after the last follow-up of TAE (SCr: 0.95 vs. 0.95 mg/dl, P=0.857; eGFR: 86.77 vs. 86.18 ml/min/1.73m2, P=0.715). The univariate analysis demonstrated that advanced age, urinary tract infection, and diabetes mellitus were significantly associated with severe bleeding during PCNL. Multivariate analysis further identified that diabetes mellitus was an independent risk factor for severe bleeding needing TAE [odds ratio (OR): 3.778, 95% confidence interval (CI):1.276-11.190, and P=0.016]. Conclusion. TAE is a safe and effective procedure to treat renal hemorrhage that cannot be resisted by conservative treatment after PCNL. Diabetes mellitus was associated with high risks of severe bleeding needing TAE after PCNL.

scholarly journals Spontaneous rupture of enormous renal angiomyolipoma in a pregnant tuberous sclerosis patient: a rare case

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zechuan Liu ◽  
Yinghua Zou ◽  
Tianshi Lv ◽  
Haitao Guan ◽  
Zeyang Fan
Keyword(s):  
Tuberous Sclerosis ◽  
Rare Complication ◽  
Arterial Embolization ◽  
Renal Angiomyolipoma ◽  
Case Presentation ◽  
Selective Arterial Embolization ◽  
Medical Termination ◽  
The Status ◽  
First Time

Abstract Background Renal angiomyolipoma (RAML) is a rare benign kidney tumour comprised of adipose tissue, smooth muscle, and blood vessels. It can cause fatal complications if it ruptures. Although there have been reports of RAMLs rupturing, it is unusual to see RAMLs rupture during pregnancy, especially in pregnant women with tuberous sclerosis (TSC). Moreover, we reported a rare complication after selective arterial embolization (SAE) for the first time, which called aseptic liquefaction necrosis. Case presentation The case is a 16-week-pregnant woman with TSC who presented with severe flank pain, which was secondary to the rupture of a large, previously unknown RAML. This was confirmed by emergency computed tomography and successfully treated with selective arterial embolization after the patient received counselling and provided prior informed written consent for medical termination of pregnancy (MTP). The patient underwent abortion 3 weeks after the SAE. The patient required drainage 2 months after the SAE because of aseptic liquefaction necrosis. During follow-up, the patient’s lesion remained stable. Conclusion RAML rupture is a rare but rather serious complication in pregnant tuberous sclerosis patients. Selective arterial embolization (SAE) should be performed immediately, and the status of the pregnancy needs to be assessed by a multidisciplinary team. We also report for the first time the rare complication of aseptic liquefaction necrosis after SAE of RAML, for which percutaneous drainage is effective.

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