scholarly journals Is Catheter Angiography Still Necessary for the Follow-Up of Spinal Malformations after Treatment?

2017 ◽  
Vol 38 (4) ◽  
pp. E29-E29
Author(s):  
M.I. Vargas ◽  
J. Boto ◽  
Z. Kulcsar
Author(s):  
Gaurav Chauhan ◽  
Vivek Singh ◽  
R. V. Phadke ◽  
Sapna Yadav ◽  
Abhishek Gupta

Postpartum cerebral angiopathy (PCA) is a rare cause of stroke in the puerperium. It usually presents with episodes of headache, seizures and neurological deficits in early post-partum period in normotensive females. CT, MRI and catheter angiography may demonstrate segmental vasoconstriction that often resolves spontaneously. PPA is generally regarded as a benign, non-relapsing and reversible disease process. We present a clinico-radiological correlative case of isolated corpus callosal hematoma in a post-partum normotensive female with evidence of intracranial vascular spasm and luminal irregularity on CT and catheter angiography. Follow up MR angiography showed resolution of the vasospasm and luminal irregularity. Patient was managed conservatively and showed resolution of the symptoms in follow up visit on 8th week. 


2020 ◽  
pp. svn-2020-000410
Author(s):  
Alexander Neumann ◽  
Jan Küchler ◽  
Claudia Ditz ◽  
Kara Krajewski ◽  
Jan Leppert ◽  
...  

BackgroundFor endovascular rescue therapy (ERT) of cerebral vasospasm (CVS) due to spontaneous subarachnoid haemorrhage (sSAH), non-compliant (NCB) and compliant (CB) balloons are used with both balloon types bearing the risk of vessel injury due to specific mechanical properties. Although severe delayed arterial narrowing after transluminal balloon angioplasty (TBA) for CVS has sporadically been described, valid data concerning incidence and relevance are missing. Our aim was to analyse the radiological follow-up (RFU) of differently TBA-treated arteries (CB or NCB).MethodsTwelve patients with utilisation of either NCB or CB for CVS were retrospectively analysed for clinical characteristics, ERT, functional outcome after 3 months and RFU. Compared with the initial angiogram, we classified delayed arterial narrowing as mild, moderate and severe (<30%, 30%–60%, respectively >60% calibre reduction).ResultsTwenty-three arteries were treated with CB, seven with NCB. The median first RFU was 11 months after TBA with CB and 10 after NCB. RFU was performed with catheter angiography in 18 arteries (78%) treated with CB and in five (71%) after NCB; magnetic resonance angiography was acquired in five vessels (22%) treated with CB and in two (29%) after NCB. Mild arterial narrowing was detected in three arteries (13%) after CB and in one (14%) after NCB. Moderate or severe findings were neither detected after use of CB nor NCB.ConclusionWe found no relevant delayed arterial narrowing after TBA for CVS after sSAH. Despite previous assumptions that CB provides for more dilatation in segments adjacent to CVS, we observed no disadvantages concerning long-term adverse effects. Our data support TBA as a low-risk treatment option.


2016 ◽  
Vol 24 (2) ◽  
pp. 262-264 ◽  
Author(s):  
Richard G. McWilliams ◽  
Tze Yuan Chan ◽  
Jonathan Smout ◽  
Francesco Torella ◽  
Robert K. Fisher

Purpose: To report the successful treatment of a type IIIb endoleak with an Amplatzer Septal Occluder. Case Report: A 76-year-old man was found to have a type IIIb endoleak in the proximal body component of a fenestrated graft at 4-year surveillance imaging; the leak was associated with rapid aneurysm growth. The anatomy of the graft and position of the fabric defect precluded treatment by relining with a secondary endograft. The defect was demonstrated with catheter angiography, sized with an angioplasty balloon, and repaired using an Amplatzer Septal Occluder. Follow-up imaging at 6 months showed no endoleak and marked reduction in the aneurysm size. Conclusion: The Amplatzer Septal Occluder may be considered as an option for managing type IIIb endoleaks.


2009 ◽  
Vol 110 (3) ◽  
pp. 492-499 ◽  
Author(s):  
Kanako Kunishima ◽  
Harushi Mori ◽  
Daisuke Itoh ◽  
Shigeki Aoki ◽  
Hiroyuki Kabasawa ◽  
...  

Object Although conventional catheter angiography is commonly used in the evaluation of intracranial arteriovenous malformations (AVMs), less invasive tools are more suitable for screening or follow-up. Older MR angiography techniques cannot provide high enough temporal and spatial resolution for assessing AVMs. Threetesla time-resolved imaging of contrast kinetics (TRICKS)—a time-resolved, contrast-enhanced 3D MR angiography technique—achieves subsecond time resolution without sacrificing spatial resolution. The purpose of this study was to assess the accuracy of TRICKS at 3 T in the evaluation of AVMs. Methods Between November 2006 and November 2007, 31 patients who were known to have AVMs underwent evaluation in a 3-T unit with the TRICKS technique. The TRICKS images were then evaluated independently by 2 radiologists for nidus detection, early venous filling detection, and Spetzler-Martin classification, and these results were compared with the results of catheter angiography. Results Time-resolved imaging of contrast kinetics achieved 96% sensitivity and 100% specificity both in nidus detection and early venous filling detection. The Spetzler-Martin grades also showed excellent correlation with catheter angiography findings (κ= 0.89). Conclusions Although this is a preliminary study, the authors' results indicate that time-resolved contrast-enhanced 3D MR angiography at 3 T is a good tool to assess AVMs, and has the potential to replace catheter angiography in screening or follow-up examinations of patients with AVMs.


Neurosurgery ◽  
2008 ◽  
Vol 63 (4) ◽  
pp. 676-683 ◽  
Author(s):  
Bae Ju Kwon ◽  
Hyuk Won Chang ◽  
Sung Won Youn ◽  
Jeong-Eun Kim ◽  
Moon Hee Han

ABSTRACT OBJECTIVE The aim of this study was to evaluate the acute and follow-up outcomes of cerebral aneurysms that perforated during endovascular treatment. METHODS Nine hundred ten patients harboring 1056 intracranial aneurysms received 1164 endovascular treatments over 11 years at our institution. Intraprocedural aneurysm perforation occurred in 20 cases (1.7%). Thirteen cases (mean size, 6.2 mm) demonstrated contrast leakage, whereas the other 7 cases (mean size, 5.3 mm) showed only nonleak coil extrusion from the aneurysms. Results of follow-up magnetic resonance angiography or catheter angiography at least 6 months after embolization were available in 11 contrast leak and 6 nonleak cases. Acute and follow-up results were reviewed. RESULTS New neurological deficits directly associated with aneurysm perforation were identified at discharge in only 4 contrast leak patients (20%). Their respective modified Rankin Scale scores were 1, 2, 3, and 5. Respective acute results in the contrast leak and nonleak groups were as follows: complete occlusion in 7 (54%) and 3 (43%), neck remnant in 3 (23%) and 4 (57%), and incomplete occlusion in 3 (23%) and 0. Respective follow-up results were as follows: major recanalization in 3 (27%) and 1 (17%), minor recanalization in 3 (27%) and 1 (17%), and stable occlusion in 5 (46%) and 4 (67%). CONCLUSION Intraprocedural aneurysm perforation with leakage of contrast appears to be associated with relatively high rates of incomplete acute results and major recanalizations during follow-up, although perforation frequently occurs in small aneurysms. Nonleak perforation may also lead to major recanalization through the potentially weak point of initial coil extrusion.


2017 ◽  
Vol 106 ◽  
pp. 74-84 ◽  
Author(s):  
Jan-Karl Burkhardt ◽  
Michelle H.J. Chua ◽  
Miriam Weiss ◽  
Angelique Sao-Mai S. Do ◽  
Ethan A. Winkler ◽  
...  

2012 ◽  
Vol 18 (1) ◽  
pp. 20-28 ◽  
Author(s):  
W. Liu ◽  
D.K. Kung ◽  
B. Policeni ◽  
J.D. Rossen ◽  
P.M. Jabbour ◽  
...  

Endovascular treatment of complex, wide-necked bifurcation cerebral aneurysms is challenging. Intra/extra-aneurysmal stent placement, the “waffle cone” technique, has the advantage of using a single stent to prevent coil herniation without the need to deliver the stent to the efferent vessel. The published data on the use of this technique is limited. We present our initial and follow-up experience with the waffle cone stent-assisted coiling (SAC) of aneurysms to evaluate the durability of the technique. We retrospectively identified ten consecutive patients who underwent SAC of an aneurysm using the waffle cone technique from July 2009 to March 2011. Clinical and angiographic outcomes after initial treatment and follow-up were evaluated. Raymond Class I or II occlusion of the aneurysm was achieved in all cases with the waffle cone technique. No intraoperative aneurysm rupture was noted. The parent arteries were patent at procedure completion. Clinical follow-up in nine patients (median 12.9 months) revealed no aneurysm rupture. Two patients had a transient embolic ischemic attack at 18 hours and three months after treatment, respectively. Catheter angiography or MRA at six-month follow-up demonstrated persistent occlusions of aneurysms in seven out of eight patients. Another patient had stable aneurysm occlusion at three-month follow-up study. Our experience in the small series suggests the waffle cone technique could be performed on complex, wide-necked aneurysms with relative safety, and it allowed satisfactory occlusions of the aneurysms at six months in most cases.


1995 ◽  
Vol 36 (4) ◽  
pp. 178-180 ◽  
Author(s):  
G. Fatone ◽  
A. Brunetti ◽  
F. Lamagna ◽  
A. Potena

2011 ◽  
Vol 114 (6) ◽  
pp. 1758-1767 ◽  
Author(s):  
Spiros L. Blackburn ◽  
William W. Ashley ◽  
Keith M. Rich ◽  
Joseph R. Simpson ◽  
Robert E. Drzymala ◽  
...  

Object Large cerebral arteriovenous malformations (AVMs) are often not amenable to direct resection or stereotactic radiosurgery (SRS) treatment. An alternative treatment strategy is staged endovascular embolization followed by SRS (Embo/SRS). The object of this study was to examine the experience at Washington University in St. Louis with Embo/SRS for large AVMs and review the results in earlier case series. Methods Twenty-one cases involving patients with large AVMs treated with Embo/SRS between 1994 and 2006 were retrospectively evaluated. The AVM size (before and after embolization), procedural complications, radiological outcome, and neurological outcome were examined. Radiological success was defined as AVM obliteration as demonstrated by catheter angiography, CT angiography, or MR angiography. Radiological failure was defined as residual AVM as demonstrated by catheter angiography, CT angiography, or MR angiography performed at least 3 years after SRS. Results The maximum diameter of all AVMs in this series was > 3 cm (mean 4.2 cm); 12 (57%) were Spetzler-Martin Grade IV or V. Clinical follow-up was available in 20 of 21 cases; radiological follow-up was available in 19 of 21 cases (mean duration of follow-up 3.6 years). Forty-three embolization procedures were performed; 8 embolization-related complications occurred, leading to transient neurological deficits in 5 patients (24%), minor permanent neurological deficits in 3 patients (14%), and major permanent neurological deficits in none (0%). Twenty-one SRS procedures were performed; 1 radiation-induced complication occurred (5%), leading to a permanent minor neurological deficit. Of the 20 patients with clinical follow-up, none experienced cerebral hemorrhage. In the 19 patients with radiological follow-up, AVM obliteration was confirmed by catheter angiography in 13, MR angiography in 2, and CT angiography in 1. Residual nidus was found in 3 patients. In patients with follow-up catheter angiography, the AVM obliteration rate was 81% (13 of 16 cases). Conclusions Staged endovascular embolization followed by SRS provides an effective means of treating large AVMs not amenable to standard surgical or SRS treatment. The outcomes and complication rates reported in this series compare favorably to the results of other reported therapeutic strategies for this very challenging patient population.


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