scholarly journals A proposal for a new pial arteriovenous fistulas grading scale for neuroendovascular procedures and literature review

2013 ◽  
Vol 20 (4) ◽  
pp. 345-353
Author(s):  
Luis Rafael Moscote-Salazar ◽  
Hernando Raphael Alvis-Miranda
Keyword(s):  
Therapeutic Strategy ◽  
Good Prognosis ◽  
Vascular Supply ◽  
Future Studies ◽  
Arteriovenous Fistulas ◽  
Cerebrovascular Lesion ◽  
Grading Scale ◽  
Type Of Injury ◽  
Preliminary Classification ◽  
Unusual Type

Abstract Pial arteriovenous fistulas are an unusual type of cerebrovascular lesion. The vascular supply of this type of injury comes from cortical and pial vessels which are not located in the dura leaflets. With the aim to make a grading scale for this type of injury, we conducted a literature search using the keywords "pial arteriovenous fistulas", "embolization" associated with "outcome". Angiographic and imagenological characteristics typically found in pial arteriovenous fistulas were taken and was developed a preliminary classification system that must be validated in future studies. Pial arteriovenous fistulas are associated with a poor natural history and the establishment of an individualized therapeutic strategy can provide a good prognosis. The endovascular management of these lesions is safe and effective.

Spinal epidural arteriovenous fistulas associated with progressive myelopathy

2007 ◽  
Vol 6 (6) ◽  
pp. 552-558 ◽  
Author(s):  
Nivaldo Silva ◽  
Anne Christine Januel ◽  
Philippe Tall ◽  
Christophe Cognard
Keyword(s):  
Magnetic Resonance Imaging ◽  
Therapeutic Strategy ◽  
Clinical Symptoms ◽  
Venous Drainage ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Arterial Access ◽  
Arteriovenous Fistulas ◽  
Progressive Myelopathy ◽  
Spinal Epidural

✓The authors report the cases of four patients who presented with progressive myelopathy (one patient had been asymptomatic for 25 years) due to spinal epidural arteriovenous fistulas (AVFs). Clinical symptoms and magnetic resonance imaging findings were similar to those of dural AVFs. In contrast to dural AVFs, angiography showed that the lesions were fed by multiple vessels and drained in one case in multiple veins. Perimedullary venous drainage was visible in three of the four cases. All fistulas were cured by embolization; arterial access was used in two cases and venous in two. The authors' aim in this paper is to emphasize the differences between dural and epidural AVFs in terms of their physiopathology and angioarchitecture as well as the therapeutic strategy.

scholarly journals An Unusual Type of Injury Due to A Thrips

1913 ◽  
Vol 6 (5) ◽  
pp. 413-414
Author(s):  
J. R. Watson
Keyword(s):  
Type Of Injury ◽  
Unusual Type

scholarly journals A new troglobite species of Habeastrum Simone, 2019 from Brazil, and support for classification in Diplommatinidae (Mollusca, Caenogastropoda)

2020 ◽  
Vol 96 (2) ◽  
pp. 639-647
Author(s):  
Luiz Ricardo L. Simone ◽  
Daniel Caracanhas Cavallari ◽  
Rodrigo Brincalepe Salvador
Keyword(s):  
Anatomical Study ◽  
Minas Gerais ◽  
Future Studies ◽  
Genus Distribution ◽  
Se Brazil ◽  
Minas Gerais State ◽  
Preliminary Classification

The genus Habeastrum Simone, 2019 was recently described based on empty shells, counting with two troglobite species. Conchological features allowed a preliminary classification in the caenogastropod family Diplommatinidae, but this family allocation was left open to future studies. Herein, we present a detailed anatomical study of newly acquired specimens, confirming the classification in Diplommatinidae. These new specimens, from Minas Gerais state, SE Brazil, belong to a new troglobite species described herein, Habeastrum strangeisp. nov. The present records extend the genus distribution ca. 1,100 km east-northeast.

Pelvic Arteriovenous Fistulas: Therapeutic Strategy in Five Cases

1990 ◽  
Vol 4 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Claude Laurian ◽  
Yvan Leclef ◽  
Fréderic Gigou ◽  
Issa Alzaoubi ◽  
Marie-Claude Riche ◽  
...  
Keyword(s):  
Therapeutic Strategy ◽  
Arteriovenous Fistulas

scholarly journals In Vivo Experimental Endovascular Uses of Cyanoacrylate in Non-Modified Arteries: A Systematic Review

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1282
Author(s):  
Kévin Guillen ◽  
Pierre-Olivier Comby ◽  
Olivier Chevallier ◽  
Anne-Virginie Salsac ◽  
Romaric Loffroy
Keyword(s):  
World War Ii ◽  
Animal Models ◽  
Animal Studies ◽  
Vascular Supply ◽  
Endovascular Embolization ◽  
World War ◽  
Arteriovenous Fistulas ◽  
Histological Criteria ◽  
Irreversible Effects

Cyanoacrylates were first used for medical purposes during World War II to close skin wounds. Over time, medical applications were developed, specifically in the vascular field. Uses now range from extravascular instillation in vascular grafting to intravascular injection for embolization. These applications were made possible by the conduct of numerous preclinical studies involving a variety of tests and outcome measures, including angiographic and histological criteria. Cyanoacrylates were first harshly criticized by vascular surgeons, chiefly due to their fast and irreversible polymerization. Over the past five years, however, cyanoacrylates have earned an established place in endovascular interventional radiology. Given the irreversible effects of cyanoacrylates, studies in animal models are ethically acceptable only if supported by reliable preliminary data. Many animal studies of cyanoacrylates involved the experimental creation of aneurysms or arteriovenous fistulas, whose treatment by endovascular embolization was then assessed. In clinical practice, however, injection into non-modified arteries may be desirable, for instance, to deprive a tumor of its vascular supply. To help investigators in this field select the animal models and procedures that are most appropriate for their objectives, we have reviewed all published in vivo animal studies that involved the injection of cyanoacrylates into non-modified arteries to discuss their main characteristics and endpoints.

scholarly journals Is the Middle Meningeal Artery the Optimal Path for Dural Arteriovenous Fistula Embolization?

2021 ◽  
Vol 12 ◽  
Author(s):  
Han Su ◽  
Kan Xu ◽  
Yiheng Wang ◽  
Jinlu Yu
Keyword(s):  
Dural Arteriovenous Fistula ◽  
Optimal Path ◽  
Middle Meningeal Artery ◽  
Good Prognosis ◽  
Modified Rankin Scale ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Type Ia ◽  
Meningeal Artery

Background: The middle meningeal artery (MMA) is the optimal arterial path for endovascular treatment (EVT) of dural arteriovenous fistulas (DAVFs). However, the details are not completely understood.Materials and Methods: We performed a retrospective study of patients who were admitted to the First Hospital of Jilin University with a diagnosis of cranial DAVF with involvement of the MMA as a feeding artery. On the basis of the arterial path chosen and the role of the MMA in the first EVT procedure, EVT was divided into three types (I–III), each of which was further divided into two subclasses (a and b). The degree of embolization was analyzed.Result: The 104 included patients ranged in age from 13 to 80 years (mean, 53.6 ± 11.8 years). There were 48 cases of hemorrhage (46.2%, 48/104). Complete embolization was achieved in the first procedure in 64.4% of cases, and success was eventually achieved using EVT (the first attempt or a subsequent attempt) in 74.1% of cases. EVT caused complications in 6.7% of cases. A modified Rankin scale score of 0 or 1 was achieved in 78.8% of patients. Statistical analyses revealed that type Ia and IIb EVTs had the lowest complete embolization rates, but no difference was found between type Ia and IIb EVTs. Types IIa and III EVT had the highest complete embolization rates. Most cases had a good prognosis.Conclusion: These findings elucidate the features of the different EVT classes defined by the first EVT procedure and the role of the MMA. The delivery of treatment via slim and tortuous MMA branches increased the failure rate of EVT. A thick, straight MMA branch is the optimal path for treatment.

scholarly journals Giant intracranial congenital hemangiopericytoma/solitary fibrous tumor: A case report and literature review

2019 ◽  
Vol 10 ◽  
pp. 75 ◽  
Author(s):  
Dimitrios Giakoumettis ◽  
Ioannis Nikas ◽  
Kalliopi Stefanaki ◽  
Antonis Kattamis ◽  
George Sfakianos ◽  
...  
Keyword(s):  
Solitary Fibrous Tumor ◽  
Therapeutic Strategy ◽  
Good Prognosis ◽  
Subtotal Resection ◽  
Neurosurgical Department ◽  
Adult Type ◽  
Therapeutic Algorithm ◽  
Fibrous Tumor ◽  
The Right ◽  
Optimal Therapeutic Strategy

Background: Hemangiopericytoma and solitary fibrous tumor (HPC/SFT) are considered to be one category according to the WHO 2016 classification of central nervous system tumors. HPC/SFT are subdivided into infantile (congenital) and adult type. Both are extremely rare entities, with little knowledge about etiology, prognosis, and optimal therapeutic strategy. Case Description: A 10-day-old girl was referred to our neurosurgical department due to hypotonia, palsy of the right oculomotor nerve, and prominent frontal fontanel. Imaging studies revealed a large occupying mass in the right middle cerebral fossa and the suprasellar cisterns. Only a subtotal resection of the tumor was possible, and postoperatively, she underwent chemotherapy (CHx). After a 3-year follow-up, the girl has minimum neurologic signs and receives no medications, and she can walk when she is supported. Conclusion: Congenital HPC/SFT is considered to have a benign behavior with a good prognosis. Treatment with gross total resection, when it is feasible, is the key to a good prognosis and low rates of recurrence. However, there is no consensus on the therapeutic strategy of a HPC/SFT, which is difficult to be completely resected. Literature lacks a therapeutic algorithm for these tumors, and thus, more clinical studies are needed to reach a consensus.

scholarly journals Targeting phospholipase D1 attenuates intestinal tumorigenesis by controlling β-catenin signaling in cancer-initiating cells

2015 ◽  
Vol 212 (8) ◽  
pp. 1219-1237 ◽  
Author(s):  
Dong Woo Kang ◽  
Chi Yeol Choi ◽  
Yong-Hee Cho ◽  
Huasong Tian ◽  
Gilbert Di Paolo ◽  
...  
Keyword(s):  
Intestinal Epithelial Cell ◽  
Therapeutic Strategy ◽  
Target Gene ◽  
Good Prognosis ◽  
Intestinal Epithelial ◽  
Self Renewal ◽  
Intestinal Tumorigenesis ◽  
Phospholipase D1 ◽  
Elevated Expression

Expression of the Wnt target gene phospholipase D1 (PLD1) is up-regulated in various carcinomas, including colorectal cancer (CRC). However, the mechanistic significance of its elevated expression in intestinal tumorigenesis remains unknown. In this study, we show that genetic and pharmacological targeting of PLD1 disrupts spontaneous and colitis-associated intestinal tumorigenesis in ApcMin/+ and azoxymethane/dextran sodium sulfate mice models. Intestinal epithelial cell–specific PLD1 overexpression in ApcMin/+ mice accelerated tumorigenesis with increased proliferation and nuclear β-catenin levels compared with ApcMin/+ mice. Moreover, PLD1 inactivation suppressed the self-renewal capacity of colon cancer–initiating cells (CC-ICs) by decreasing expression of β-catenin via E2F1-induced microRNA (miR)-4496 up-regulation. Ultimately, low expression of PLD1 coupled with a low level of CC-IC markers was predictive of a good prognosis in CRC patients, suggesting in vivo relevance. Collectively, our data reveal that PLD1 has a crucial role in intestinal tumorigenesis via its modulation of the E2F1–miR-4496–β-catenin signaling pathway. Modulation of PLD1 expression and activity represents a promising therapeutic strategy for the treatment of intestinal tumorigenesis.

scholarly journals Arteriovenous fistulas of the Vein of Galen region in adults: Endovascular treatment

2020 ◽  
Vol 26 (6) ◽  
pp. 757-766
Author(s):  
Laura Paúl ◽  
Alfredo Casasco ◽  
Alberto Gil ◽  
Aitziber Aleu ◽  
Leopoldo Guimaraens
Keyword(s):  
Endovascular Treatment ◽  
Complete Resolution ◽  
Therapeutic Strategy ◽  
Clinical Presentation ◽  
Venous Drainage ◽  
Vein Of Galen ◽  
Arteriovenous Fistulas ◽  
Complete Obliteration ◽  
Endovascular Approach ◽  
Low Prevalence

Purpose Arteriovenous fistulas of the Vein of Galen region in adults (Ad-VGAVF) are an uncommon entity with specific anatomic features. The aim of this article is to present our experience in the endovascular treatment of this pathology and to propose a therapeutic strategy based precisely on the angioarchitecture of these lesions. Materials and methods During a 20-year period, 10 patients underwent endovascular treatment of Ad-VGAVF. They were nine men and one woman with a mean age of 50 years (23–66 years) treated with the same embolization strategy. Clinical presentation, angiographic characteristics, therapeutic strategy, and clinical outcomes were recorded. Results All patients were treated exclusively by endovascular approach. Transarterial access was performed in eight patients and combined transvenous and transarterial access in two. Complete obliteration of the fistula was obtained in all patients. There were no intraprocedural complications. Post-embolization neurological symptoms occurred in 5 of 10 with complete resolution at six months in all of them. Conclusion Arteriovenous fistulas of the Vein of Galen region in adults present uniform angioarchitecture despite their low prevalence. Based on this constant angioarchitecture and especially on the features of its venous drainage, judicious embolization strategy is feasible and effective. Ten cases treated entirely by endovascular approach with excellent clinical and angiographic outcomes show this treatment like a curative alternative for this entity of deep topography and severe prognosis.

Immunotherapy in critical illness

2016 ◽  
Author(s):  
Hans-Dieter Volk ◽  
Levent Akyüz
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Immune Modulation ◽  
Therapeutic Strategy ◽  
Future Studies ◽  
Clinical Endpoints ◽  
Use Of Resources ◽  
The Right ◽  
Economic Use ◽  
Experimental Level

Immunotherapy in critically-ill patients is only feasible at clinical experimental level; no therapy has been approved so far. To develop a potential therapeutic strategy we need to know the pathogen, immune status of the patient, and interaction between the particular pathogen and immune cells to readjust the patient´s individually imbalanced immunological responsiveness. Giving the right treatment at the right time is crucial for a better outcome and the best economic use of resources. The process starts by matching the therapeutic selection to the clinical need. Personalized immunotherapy, highly dependent on the available biomarker, is required. Future studies on new immunotherapeutic approaches in critically-ill patients can only be interpreted in combination with immunological biomarker analyses. Immune modulation is a promising approach despite many disappointing results and there is a clear need for immunological stratification of critically-ill patients for improved efficacy. The search continues for new clinical endpoints in surviving patients with medical and health-economical impact.

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