Successful endovascular treatment of extracranial arteriovenous malformation of a head: a case report

Introduction. Arteriovenous malformations (AVM) of the head represent the rare lesions that have a congenital, traumatic or post-infectious nature. In the last decade, endovascular methods have become the most prevalent in the treatment of AVM. Staged embolization is performed to achieve maximum eﬀect and minimize the complications.Case report. A 30-year-old female patient is presented with complaints of enlarged vessels in the frontal and parietal regions. CT-angiography scan and cerebral angiography showed extracranial AVM of the fronto-parietal regions with aﬀerent vascular supply from the right and left superﬁcial temporal and ophtalmic arteries with signiﬁcant expansion of the aﬀerent arteries and the presence of varix dilatation of the draining veins. Two-stage endovascular embolization of AVM was performed. The ﬁrst stage was embolization of the aﬀerent vessels from the left superﬁcial temporal artery system with exclusion of 60–65% AVM volume. Three months later, the second stage was performed with embolization of the afferent vessels from the right superﬁcial temporal artery system and the exclusion of 75–80% of the residual volume of AVM. The non-adhesive composition SQUIDR12 (Emboﬂu, Switzerland) and glue composition PHILR25% (Microvention, USA) were used. A good aesthetic eﬀect was achieved. Postoperative complications were not observed. There was no recurrence during the observation within a year.Summary. The staging and the use of various liquid embolization agents in the treatment of AVM of the head allow to achieve a good aesthetic outcome and prevent complications associated with facial soft tissue necrosis.

Download Full-text

Traumatic arteriovenous fistula of the superficial temporal artery

Jornal Vascular Brasileiro ◽

10.1590/jvb.2014.008 ◽

2014 ◽

Vol 13 (1) ◽

pp. 39-42 ◽

Cited By ~ 1

Author(s):

Otacílio de Camargo Júnior ◽

Márcia Fayad Marcondes de Abreu ◽

Guilherme Camargo Gonçalves de Abreu ◽

Sthefano Atique Gabriel ◽

Isabella Maria Machado da Silva

Keyword(s):

Arteriovenous Fistula ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Surgical Removal ◽

Conventional Surgery ◽

Arteriovenous Fistulae ◽

Motorcycle Accident ◽

Pulsatile Mass ◽

Endovascular Methods ◽

The Right

Arteriovenous fistulae of the superficial temporal artery are rare, and their principal cause is traumas. Complications include pulsatile mass, headache, hemorrhage and deformities that compromise esthetics. Treatment can be performed using conventional surgery or endovascular methods. The authors describe a case of a 44-year-old male patient who developed a large pulsating mass, extending from the preauricular region to the right parietotemporal and frontal regions after a motorcycle accident. The treatment chosen was complete surgical removal of the pulsatile mass and ligature of the vessels feeding the fistula.

Download Full-text

Targeted Extracranial-Intracranial Bypass With Intra-Aneurysmal Administration of Indocyanine Green: Case Report

Operative Neurosurgery ◽

10.1227/neu.0b013e3181f8889e ◽

2010 ◽

Vol 67 (suppl_2) ◽

pp. onsE527-onsE531 ◽

Cited By ~ 3

Author(s):

Mark D. Bain ◽

Shaye I. Moskowitz ◽

Peter A. Rasmussen ◽

Ferdinand K. Hui

Keyword(s):

Indocyanine Green ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Superficial Temporal Artery ◽

Giant Aneurysm ◽

Temporal Artery ◽

Endovascular Embolization ◽

Parent Vessel ◽

Bypass Patency ◽

The Right

ABSTRACT BACKGROUND AND IMPORTANCE: Early origin of the middle cerebral artery M2 segment is a normal variant. When such a vessel is occluded proximally, the parenchyma distal to the vessel may become ischemic. Targeted extracranial to intracranial bypass to such a specific branch may preserve perfusion to the end organ. We describe the use of intra-aneurysmal injection of indocyanine green to identify a target middle cerebral artery branch (MCA) for bypass, immediately followed by proximal parent vessel sacrifice via endovascular embolization. CLINICAL PRESENTATION: A 45-year-old woman presented to an outside hospital with headaches. Magnetic resonance imaging revealed a giant aneurysm of the right MCA. The aneurysm gave rise to an M2 branch that supplied the right anterior frontal operculum, as well as the anterolateral portion of the superior temporal gyri. Balloon test occlusion was nondiagnostic because of the territory involved, and the risk of sizable infarction after vessel sacrifice was thought to be high. Craniotomy and targeted extracranial to intracranial bypass to an M4 opercular branch was performed with intra-aneurysmal injection of indocyanine green. In our combined endovascular/open cerebrovascular suite, an opercular MCA branch that fluoresced during the first-pass arterial circulation of indocyanine green was identified, and a superficial temporal artery to MCA bypass was performed. Angiographic verification of bypass patency was confirmed, followed by embolic occlusion of the giant aneurysm with preservation of flow to the parenchyma at risk through the bypass. CONCLUSION: Targeted bypass to distal branches is feasible with intra-arterial and intra-aneurysmal injection of indocyanine green, allowing confident preservation of blood supply to areas distal to the sacrificed vessel.

Download Full-text

Superficial temporal artery access for percutaneous coronary artery stenting during the COVID-19 pandemic: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa520 ◽

2020 ◽

Author(s):

Ádám Csavajda ◽

Olivier F Bertrand ◽

Béla Merkely ◽

Zoltán Ruzsa

Keyword(s):

Coronary Artery ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Coronary Intervention ◽

Femoral Access ◽

St Segment Elevation ◽

Invasive Cardiology ◽

Percutaneous Coronary ◽

Diagnostic Angiography ◽

The Right

Abstract Background The COVID-19 pandemic creates new challenges for healthcare, including invasive cardiology. Case summary We discuss the case of a 65-year-old man who presented with non-ST segment elevation myocardial infarction combined with bilateral pneumonia. The patient had known severe iliac artery lesions with prior interventions and bilateral subclavian artery occlusions. After unsuccessful femoral artery access, the diagnostic angiography and the right coronary artery percutaneous coronary intervention were successfully performed from ultrasound-guided lower superficial temporal artery access. Discussion We showed that superficial temporal access can be used as an alternate access site for diagnostic coronary angiography and intervention when standard wrist and femoral access sites are not readily accessible.

Download Full-text

Presentation and surgical management of a superficial temporal artery pseudoaneurysm: A case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.01.072 ◽

2021 ◽

Vol 79 ◽

pp. 368-370

Author(s):

Hannah Muir ◽

Kirsty Cowan ◽

Peter Steele ◽

John Jeff Downie

Keyword(s):

Case Report ◽

Surgical Management ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Artery Pseudoaneurysm

Download Full-text

Combining Internal Carotid Artery Occlusion with Intermediate-Flow Bypass for Treating Large-Giant Cavernous Sinus Segment Aneurysms: Case Report and Review of Literature

Nepal Journal of Neuroscience ◽

10.3126/njn.v16i1.24431 ◽

2019 ◽

Vol 16 (1) ◽

pp. 42-47

Author(s):

Robin Bhattarai ◽

Chuan Chen ◽

Chao Feng Liang ◽

Teng Chao Huang ◽

Hui Wang ◽

...

Keyword(s):

Radial Artery ◽

Cavernous Sinus ◽

Internal Carotid ◽

Treatment Effectiveness ◽

Artery Bypass ◽

Bypass Graft ◽

Superficial Temporal Artery ◽

Temporal Artery ◽

Balloon Occlusion ◽

The Right

We summarize the treatment effectiveness and experience of a patient who underwent internal carotid balloon occlusion combined with Intermediate-flow bypass as a treatment for large-giant cavernous sinus segment internalcarotid artery (CS ICA) aneurysms. A 62-year-old woman presented with a large aneurysm on the right side of the cavernoussinus with dizziness for about two years and Oculomot or nerve palsy. An extra cranial intracranial (EC-IC) Intermediate-flow by pass using a radial artery bypass graft (RABG) and proximal balloon occlusion of the Right ICA were performed. The patient experienced no new neurologic deficit after this treatment. Follow up radiologic evaluations using Computed Tomography Angiography revealed complete aneurysm occlusion. For patients with large-giant CS ICA aneurysms, treatment of ICA occlusion combined with Intermediate-flow superficial temporal artery-Radial artery-middle cerebralartery bypass surgery was an effective and safe surgical strategy.

Download Full-text