More articles from Interventional
- Safety and Efficacy of Transvenous Embolization of Ruptured Brain Arteriovenous Malformations as a Last Resort: A Prospective Single-Arm Study
Twenty-one consecutive patients with ruptured brain AVMs who underwent transvenous embolization were prospectively followed between November 2016 and November 2018. Complete AVM nidus obliteration was shown in 16 (84%) of 19 patients. One (5%) patient with a small residual nidus after treatment showed complete obliteration at 13-month follow-up. There were 5 hemorrhages and 1 infarction; 4 patients' symptoms improved gradually. Transvenous embolization can be performed only in highly selected hemorrhagic brain AVMs with high complete obliteration rates, but it should not be considered as a first-line treatment.
- Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts
A color-mapping method for 4D-CTA is presented for improved and enhanced visualization of the cerebral vasculature hemodynamics. This method was applied to detect cranial AVFs. Thirty-one patients were included, 21 patients with and 10 without an AVF. Arterialization of venous structures in AVFs was accurately visualized using color-mapping. There was high sensitivity (86%–100%) and moderate-to-high specificity (70%–100%) for the detection of AVFs on color-mapping 4D-CTA, even without the availability of dynamic subtraction rendering. Arterialization of venous structures can be visualized using color-mapping of 4D-CTA and proves to be accurate for the detection of cranial AVFs.
- Posterior Fossa Dural Arteriovenous Fistulas with Subarachnoid Venous Drainage: Outcomes of Endovascular Treatment
Twenty-six patients treated endovascularly for posterior fossa dural AVFs, type III, IV, or V, were included in this study. One hundred percent of the dural AVFs were occluded. A transarterial approach was performed in 23 dural AVFs; a combined transarterial and transvenous approach, in 2 dural AVFs; and a transvenous approach alone, in 1 dural AVF. The middle meningeal artery was the most common artery chosen to inject embolic liquid (12/26). Procedure-related morbidity was 15.4% at 24 hours, 7.7% at discharge, and 0% at 6 months. Procedure-related mortality was 0%. The authors conclude that endovascular treatment offers high occlusion rates for posterior fossa dural AVFs with low morbidity and mortality rates.