scholarly journals Role of the Cervical Anterior Spinal Artery in the Endovascular Treatment of Vascular Diseases: Bystander, Accomplice, Victim, or Friend?

2021 ◽  
Vol 12 ◽  
Author(s):  
Kun Zhang ◽  
Chao Li ◽  
Kun Hou ◽  
Jinlu Yu
Keyword(s):  
Blood Flow ◽  
Arteriovenous Malformation ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Vascular Diseases ◽  
Posterior Circulation ◽  
Anterior Spinal Artery ◽  
Collateral Channel

The cervical anterior spinal artery (ASA) is a very important artery arising from the intracranial vertebral artery (VA). It can play different roles in endovascular treatment (EVT) of spinal vascular diseases. The current understanding of these roles is incomplete; therefore, we performed this review. We found that cervical ASA can be involved in many spinal vascular diseases, such as arteriovenous fistula (AVF), arteriovenous malformation (AVM), and aneurysm, and can serve as a collateral channel in proximal VA occlusion. In AVF and AVM, when the cervical ASA is involved, it often plays the role of an accomplice or victim because it acts as the feeder or as a bystander that does not provide blood flow to the AVF and AVM. In cervical ASA aneurysm, the ASA is a victim. During EVT of VA aneurysms or stenoses, the cervical ASA ostia can be covered or occluded, resulting in ASA ischemia. In this situation, the ASA is a victim. In VA occlusion or the subclavian steal phenomenon, the cervical ASA can serve as a collateral channel to provide blood flow to the posterior circulation. In this case, the ASA plays the role of a friend. According to the role of the cervical ASA in spinal vascular diseases, EVT should be determined “case by case.” Most importantly, when EVT is performed to treat these diseases, the cervical ASA axis must be preserved. Therefore, understanding the role of the cervical ASA in spinal vascular diseases is crucial.

scholarly journals Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Shuhei Kawabata ◽  
Hajime Nakamura ◽  
Takeo Nishida ◽  
Masatoshi Takagaki ◽  
Nobuyuki Izutsu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Anterior Cranial Fossa ◽  
Maxillary Artery ◽  
Flow Reduction ◽  
Cranial Fossa ◽  
Embolic Materials

ABSTRACT Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, high blood flow from the internal maxillary artery (IMA) often impedes penetration of embolic materials into the shunt pouch. Therefore, reducing blood flow from the IMA before embolization can increase the success rate. In the present case, to reduce blood flow from branches of the IMA, we inserted surgical gauze infiltrated with xylocaine and epinephrine into bilateral nasal cavities. Using this method, we achieved curative TAE with minimal damage to the nasal mucosa. Transnasal flow reduction is an easy, effective and minimally invasive method. This method should be considered in the endovascular treatment of ACF–dAVF, especially in patients with high blood flow from theIMA.

scholarly journals Digital intravascular pressure wave recording during endovascular treatment reveals abnormal shunting flow in vertebral venous fistula of the vertebral artery: illustrative case

2021 ◽  
Vol 2 (2) ◽  
Author(s):  
Yoshiteru Shimoda ◽  
Shinya Sonobe ◽  
Kuniyasu Niizuma ◽  
Toshiki Endo ◽  
Hidenori Endo ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endovascular Treatment ◽  
Vertebral Artery ◽  
Resistance Index ◽  
Illustrative Case ◽  
Limb Weakness ◽  
Dicrotic Notch ◽  
The Central Nervous System ◽  
Venous Fistula ◽  
The Right

BACKGROUND An arteriovenous fistula is an abnormal arteriovenous shunt between an artery and a vein, which often leads to venous congestion in the central nervous system. The blood flow near the fistula is different from normal artery flow. A novel method to detect the abnormal shunting flow or pressure near the fistula is needed. OBSERVATIONS A 76-year-old woman presented to the authors’ institute with progressive right upper limb weakness. Right vertebral angiography showed a fistula between the right extracranial vertebral artery (VA) and the right vertebral venous plexus at the C7 level. The patient underwent endovascular treatment for shunt flow reduction. Before the procedure, blood pressures were measured at the proximal VA, distal VA near the fistula, and just at the fistula and drainer using a microcatheter. The blood pressure waveforms were characteristically different in terms of resistance index, half-decay time, and appearance of dicrotic notch. The fistula was embolized with coils and N-butyl cyanoacrylate solution. LESSONS During endovascular treatment, the authors were able to digitally record the vascular pressure waveform from the tip of the microcatheter and succeeded in calculating several parameters that characterize the shunting flow. Furthermore, these parameters could help recognize the abnormal blood flow, allowing a safer endovascular surgery.

scholarly journals The role of oxygen transport in atherosclerosis and vascular disease

2020 ◽  
Vol 17 (165) ◽  
pp. 20190732 ◽  
Author(s):  
John Tarbell ◽  
Marwa Mahmoud ◽  
Andrea Corti ◽  
Luis Cardoso ◽  
Colin Caro
Keyword(s):  
Blood Flow ◽  
Vascular Disease ◽  
Oxygen Transport ◽  
Intimal Hyperplasia ◽  
Hypoxia Inducible Factor ◽  
Vascular Diseases ◽  
Vascular Wall ◽  
Vasa Vasorum ◽  
Mechanical Factors

Atherosclerosis and vascular disease of larger arteries are often associated with hypoxia within the layers of the vascular wall. In this review, we begin with a brief overview of the molecular changes in vascular cells associated with hypoxia and then emphasize the transport mechanisms that bring oxygen to cells within the vascular wall. We focus on fluid mechanical factors that control oxygen transport from lumenal blood flow to the intima and inner media layers of the artery, and solid mechanical factors that influence oxygen transport to the adventitia and outer media via the wall's microvascular system—the vasa vasorum (VV). Many cardiovascular risk factors are associated with VV compression that reduces VV perfusion and oxygenation. Dysfunctional VV neovascularization in response to hypoxia contributes to plaque inflammation and growth. Disturbed blood flow in vascular bifurcations and curvatures leads to reduced oxygen transport from blood to the inner layers of the wall and contributes to the development of atherosclerotic plaques in these regions. Recent studies have shown that hypoxia-inducible factor-1α (HIF-1α), a critical transcription factor associated with hypoxia, is also activated in disturbed flow by a mechanism that is independent of hypoxia. A final section of the review emphasizes hypoxia in vascular stenting that is used to enlarge vessels occluded by plaques. Stenting can compress the VV leading to hypoxia and associated intimal hyperplasia. To enhance oxygen transport during stenting, new stent designs with helical centrelines have been developed to increase blood phase oxygen transport rates and reduce intimal hyperplasia. Further study of the mechanisms controlling hypoxia in the artery wall may contribute to the development of therapeutic strategies for vascular diseases.

scholarly journals Cerebral Arteriovenous Malformations with Associated Arterial Aneurysms: Hemodynamic and Therapeutic Considerations

1988 ◽  
Vol 15 (2) ◽  
pp. 130-134 ◽  
Author(s):  
Douglas Kondziolka ◽  
Bruce J. Nixon ◽  
Pierre Lasjaunias ◽  
Pierre Lasjaunias ◽  
William S. Tucker ◽  
...  
Keyword(s):  
Blood Flow ◽  
Arteriovenous Malformation ◽  
Endovascular Treatment ◽  
Arteriovenous Malformations ◽  
Local Blood Flow ◽  
Cerebral Arteriovenous Malformations ◽  
Regional Hemodynamics ◽  
The Common ◽  
Arterial Aneurysms ◽  
Therapeutic Considerations

ABSTRACT:The common vascular anomalies of cerebral aneurysm and arteriovenous malformation may exist independently, or together as part of a closely related hemodynamic pairing. Resection or embolization of an AVM may be followed by a decrease in local blood flow, and lead to regression of a suitably situated proximal aneurysm. However, aneurysms located outside the angioarchitecture of the AVM, which remain flow-unrelated to the malformation, will likely not regress, and may in fact enlarge. Two cases are presented which demonstrate these vascular relationships, in order to better understand the regional hemodynamics of these anomalies prior to surgical or endovascular treatment planning.

Excision of a congenital suboccipital vertebral arteriovenous fistula

1972 ◽  
Vol 37 (4) ◽  
pp. 452-456 ◽  
Author(s):  
Albert D. Bartal ◽  
Morris J. Levy
Keyword(s):  
Arteriovenous Malformation ◽  
Vertebral Artery ◽  
Arteriovenous Fistula ◽  
Surgical Approach ◽  
Left Ventricular ◽  
Content Type ◽  
Vertebral Arteriovenous Fistula ◽  
Cardiac Enlargement ◽  
Major Consideration ◽  
Fine Print

✓ This report describes the successful excision of a congenital vertebral arteriovenous malformation in an 8-year-old child. There was mild effort dyspnea and left ventricular cardiac enlargement; a left-to-right vertebral artery steal across the basilar trifurcation was a major consideration in planning the surgical approach.

scholarly journals Spinal Arteriovenous Malformation Associated with a Radicular Arteriovenous Fistula Suggested a Metameric Disease

2003 ◽  
Vol 9 (1) ◽  
pp. 75-78 ◽  
Author(s):  
A. Nishio ◽  
K. Ohata ◽  
T. Takami ◽  
T. Gotoh ◽  
N. Tsuyuguchi ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Arteriovenous Malformation ◽  
Arteriovenous Fistula ◽  
Anterior Spinal Artery ◽  
Low Back ◽  
Spinal Angiography ◽  
Spinal Arteriovenous Malformation ◽  
Four Levels ◽  
Spinal Avm

A spinal intramedullary arteriovenous malformation (AVM) associated with a radicular arteriovenous fistula (AVF) is reported. The patient had mild myelopathy and low back pain. Spinal angiography revealed the AVM fed by the anterior spinal artery via left T10, T11 and right L1 radiculomedullary arteries and the radiculopial arteries of left L1, L2 and right T11, L3 levels and the radicular AVF at the left L4 level. There were three radiculomedullary arteries within four levels in our case. This spinal AVM associated with a radicular AVF is considered a genetic nonhereditary lesion with metameric link.

Effect of a Surgically Created Side-to-Side Arteriovenous Fistula on Heat Elimination from the Human Hand and Forearm: Evidence for a Critical Role of Venous Resistance in Determining Fistular Flow

1978 ◽  
Vol 55 (4) ◽  
pp. 349-353
Author(s):  
W. F. M. Wallace ◽  
J. P. Jamison
Keyword(s):  
Blood Flow ◽  
Cold Stress ◽  
Arteriovenous Fistula ◽  
Flow Rate ◽  
Temperature Regulation ◽  
Critical Role ◽  
Human Hand ◽  
Superficial Vein ◽  
Heat Elimination

1. In eight patients with a unilateral fistula between the radial artery and a nearby superficial vein, heat elimination from both hand and forearm, as measured by calorimetry, was always substantially greater on the side of the fistula (mean excess from hand-plus-forearm 889 J/min). 2. Fistular blood flow measured by hand-plus-forearm plethysmography in these patients averaged 431 ml/min. Correlation between fistular blood flow and heat elimination was poor (r = 0.70, P < 0.06), probably because heat elimination due to the fistula takes place mainly from veins, whose pattern varies from patient to patient. 3. Approximately half of the total increased heat elimination due to the fistula is from the hand. Occlusion of the circulation to the hand caused fistular flow rate to be reduced by about half. This suggests that the main resistance to fistular flow is venous, proximal veins offering a similar resistance to distal veins. 4. The obligatory heat loss due to the fistula is unlikely to embarrass temperature regulation, except in severe cold stress.

scholarly journals Endovascular management of fusiform aneurysms in the posterior circulation: the era of flow diversion

2017 ◽  
Vol 42 (6) ◽  
pp. E14 ◽  
Author(s):  
Ahmed J. Awad ◽  
Justin R. Mascitelli ◽  
Reham R. Haroun ◽  
Reade A. De Leacy ◽  
Johanna T. Fifi ◽  
...  
Keyword(s):  
Natural History ◽  
Endovascular Treatment ◽  
Coil Embolization ◽  
Posterior Circulation ◽  
Flow Diversion ◽  
Endovascular Management ◽  
True Aneurysm ◽  
Aneurysm Neck

Fusiform aneurysms are uncommon compared with their saccular counterparts, yet they remain very challenging to treat and are associated with high rates of rebleeding and morbidity. Lack of a true aneurysm neck renders simple clip reconstruction or coil embolization usually impossible, and more advanced techniques are required, including bypass, stent-assisted coiling, and, more recently, flow diversion. In this article, the authors review posterior circulation fusiform aneurysms, including pathogenesis, natural history, and endovascular treatment, including the role of flow diversion. In addition, the authors propose an algorithm for treatment based on their practice.

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