scholarly journals Preoperative Devascularization of Choroid Plexus Tumors: Specific Issues about Anatomy and Embolization Technique

2021 ◽  
Vol 11 (5) ◽  
pp. 540
Author(s):  
Valentina Baro ◽  
Joseph Domenico Gabrieli ◽  
Giacomo Cester ◽  
Ignazio D’Errico ◽  
Andrea Landi ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Lateral Ventricle ◽  
Choroid Plexus Carcinoma ◽  
Embolic Agent ◽  
Preoperative Embolization ◽  
Anterior Choroidal Artery ◽  
Choroid Plexus Tumors ◽  
Occlusion Time ◽  
Anterior Choroidal ◽  
Choroidal Artery

(1) Background: Surgical treatment of choroid plexus tumors is challenging, burdened by a notable risk of bleeding. Neoadjuvant chemotherapy and preoperative embolization have been attempted, with encouraging results; however, the consensus on these procedures is lacking. (2) Methods: We present a case of a 10-month-old girl who underwent preoperative embolization of a hemorrhagic choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, followed by total resection. (3) Results: The endovascular procedure was successfully completed, despite the rectification of the anterior choroidal artery associated with the absence of flow proximal to the plexal point. Minimal bleeding was observed during resection and the patient remained neurologically intact. (4) Conclusions: The time from entrance to exit in the anterior choroidal artery should be monitored and regarded as a potential ‘occlusion time’ in this specific group of patients. Nevertheless, our case supports the feasibility and effectiveness of preoperative embolization of a choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, without complications. Furthermore, we suggest the use of a fast-embolic agent, such as N-butyl cyanoacrylate glue, as the preferred agent for this specific pathology and patient population.

Preoperative embolization of choroid plexus papilloma with Onyx via the anterior choroidal artery: technical note

2012 ◽  
Vol 28 (11) ◽  
pp. 1955-1958 ◽  
Author(s):  
Felipe Padovani Trivelato ◽  
Luciano Bambini Manzato ◽  
Marco Túlio Rezende ◽  
Pedro Moreira Coelho Barroso ◽  
Rodrigo Moreira Faleiro ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Choroid Plexus Papilloma ◽  
Technical Note ◽  
Preoperative Embolization ◽  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery ◽  
Plexus Papilloma

scholarly journals Patency of the anterior choroidal artery covered with a flow-diverter stent

2015 ◽  
Vol 123 (6) ◽  
pp. 1540-1545 ◽  
Author(s):  
Hiroaki Neki ◽  
Jildaz Caroff ◽  
Pakrit Jittapiromsak ◽  
Nidhal Benachour ◽  
Cristian Mihalea ◽  
...  
Keyword(s):  
Choroid Plexus ◽  
Clinical Symptoms ◽  
Flow Diverter ◽  
Anterior Choroidal Artery ◽  
Parent Vessel ◽  
Flow Diverter Stent ◽  
Anterior Choroidal ◽  
Long Course ◽  
Choroidal Artery

OBJECT The concept of the flow-diverter stent (FDS) is to induce aneurysmal thrombosis while preserving the patency of the parent vessel and any covered branches. In some circumstances, it is impossible to avoid dangerously covering small branches, such as the anterior choroidal artery (AChA), with the stent. In this paper, the authors describe the clinical and angiographic effects of covering the AChA with an FDS. METHODS Between April 2011 and July 2013, 92 patients with intracranial aneurysms were treated with the use of FDSs in the authors’ institution. For 20 consecutive patients (21.7%) retrospectively included in this study, this involved the unavoidable covering of the AChA with a single FDS during endovascular therapy. AChAs feeding the choroid plexus were classified as the long-course group (14 cases), and those not feeding the choroid plexus were classified as the short-course group (6 cases). Clinical symptoms and the angiographic aspect of the AChA were evaluated immediately after stent delivery and during follow-up. Neurological examinations were performed to rule out hemiparesis, hemihypesthesia, hemianopsia, and other cortical signs. RESULTS FDS placement had no immediate effect on AChA blood flow. Data were obtained from 1-month clinical follow-up in all patients and from midterm angiographic follow-up in 17 patients (85.0%), with a mean length of 9.8 ± 5.4 months. No patient in either group complained of transient or permanent symptoms related to an AChA occlusion. In all cases, the AChA remained patent without any flow changes. CONCLUSIONS The results of this study suggest that when impossible to avoid, the AChA may be safely covered with a single FDS during intracranial aneurysm treatment, irrespective of anatomy and anastomoses.

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.

Microanatomy of the Intrachoroidal Vasculature of the Lateral Ventricle

2005 ◽  
Vol 57 (suppl_1) ◽  
pp. 22-36 ◽  
Author(s):  
Slobodan Marinković ◽  
Hirohiko Gibo ◽  
Milan Milisavljević ◽  
Vuk Djulejić ◽  
Vladimir T. Jovanović
Keyword(s):  
Choroid Plexus ◽  
Common Trunk ◽  
Lateral Part ◽  
Detailed Knowledge ◽  
Anterior Choroidal Artery ◽  
Mean Diameter ◽  
Choroid Plexuses ◽  
Lateral Posterior ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract OBJECTIVE: Intraventricular surgery requires a detailed knowledge of the microanatomy of the choroid plexus vasculature. METHODS: Twenty choroid plexuses were microdissected, and two additional plexuses were prepared for microscopic examination. RESULTS: The choroid plexus was perfused primarily by the anterior choroidal artery (AChA) and the lateral posterior choroidal artery (LPChA). The AChA, which averaged 650 μm in diameter, most often (in 75% of cases) divided into the medial and lateral trunks, which averaged 450 μm in diameter. The medial trunk gave off the bush-like intrachoroidal branches, whereas the lateral trunk divided into the parallel arteries. The inferior LPChA was present in 50% of the hemispheres, both the inferior and superior LPChAs in 40%, and their common trunk in 10%. In 40%, the LPChA, which averaged 670 μm in diameter, divided into the terminal trunks, with a mean diameter of 490 μm. The anastomoses involving the trunks of the LPChA and other choroidal arteries averaged 310 μm in diameter. All primary intrachoroidal branches of the AChA and LPChA were divided into three groups. The parallel branches, which averaged from 220 to 230 μm in diameter, coursed along the lateral part of the choroid plexus. The tortuous glomus vessels, which averaged 310 μm in size, originated from the AChA (45%), the LPChA (15%), or both (40%). The bush-like vessels, with a mean diameter between 155 and 190 μm, ramified into smaller twigs, up to the intrachoroidal capillaries. CONCLUSION: The data obtained on the microanatomy of the intrachoroidal vasculature may have certain neurosurgical implications.

The anterior choroidal artery

1978 ◽  
Vol 14 (2) ◽  
pp. 160
Author(s):  
SY Rho ◽  
SH Cha ◽  
WH Lee ◽  
JS Kim
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

scholarly journals Paracentral homonymous hemianopic scotoma caused by anterior choroidal artery infarction

QJM ◽  
2021 ◽  
Author(s):  
A Mitsutake ◽  
Y Nagashima ◽  
H Mori ◽  
H Sawamura ◽  
T Toda
Keyword(s):  
Anterior Choroidal Artery ◽  
Anterior Choroidal ◽  
Choroidal Artery

Management of an Uncommon Complication: Anterior Choroidal Artery Occlusion by Posterior Clinoid Process Detected Through Intraoperative Monitoring After Clipping of Paraclinoid Aneurysm: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Walter Marani ◽  
Francisco Mannará ◽  
Kosumo Noda ◽  
Tomomasa Kondo ◽  
Nakao Ota ◽  
...  
Keyword(s):  
Intraoperative Monitoring ◽  
Motor Evoked Potential ◽  
Japanese Woman ◽  
Motor Deficits ◽  
Anterior Choroidal Artery ◽  
Diffusion Weighted Images ◽  
Ct Angiogram ◽  
Paraclinoid Aneurysms ◽  
Anterior Choroidal ◽  
Choroidal Artery

Abstract Despite technological advances in endovascular therapy, surgical clipping of paraclinoid aneurysms remains an indispensable treatment option and has an acceptable profile risk. Intraoperative monitoring of motor and somatosensory evoked potentials has proven to be an effective tool in predicting and preventing postoperative motor deficits during aneurysm clipping.1,2 We describe the case of a 61-yr-old Japanese woman with a history of hypertension and smoking. During follow-up for bilateral aneurysms of ophthalmic segment of the internal carotid artery (ICA), left-sided aneurysm growth was detected. A standard pterional approach with extradural clinoidectomy was used to approach the aneurysm. After clipping, a significant intraprocedural change in motor evoked potential (MEP) amplitude was observed despite native vessel patency was confirmed through micro-Doppler and indocyanine green video angiography.3-5 After extensive dissection of the sylvian fissure and exposure of the communicating segment of ICA, the anterior choroidal artery was found to be compressed and occluded by the posterior clinoid because of an inadvertent shift of the ICA after clip application and removal of brain retractors. Posterior clinoidectomy was performed intradurally with microrongeur and MEP amplitude returned readily to baseline values. Computed tomography (CT) angiogram demonstrated complete exclusion of the aneurysm, and magnetic resonance imaging (MRI) was negative for postoperative ischemic lesions on diffusion weighted images. The patient tolerated the procedure well and was discharged home on postoperative day 3 with modified Rankin Scale (mRS) 0. The patient signed the Institutional Consent Form to undergo the surgical procedure and to allow the use of her images and videos for any type of medical publications.

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