Endovascular Therapy for Arteriovenous Malformation
|
|
- Alexander Ball
- 5 years ago
- Views:
Transcription
1 Endovascular Therapy for Arteriovenous Malformation Wayne F. Yakes, MD Vascular malformations involving the spinal cord are technically challenging clinical entities to diagnosis and ultimately treat. Our experience in treating over 400 such lesions involving diverse anatomic locations is presented here. Experience dictates that treatment aims at cure rather than palliation. Our results and treatment modality are discussed here. Introduction. Vascular malformations constitute some of the most difficult diagnostic and therapeutic enigmas that can be encountered in the practice of medicine. The clinical presentations are extremely protean and can range from an asymptomatic birthmark to fulminate life-threatening congestive heart failure. Attributing any of these extremely varied symptoms that a patient may present with to a vascular malformation can be challenging to the most experienced clinician. Compounding this problem is the extreme rarity of these lesions. If a clinician sees one patient every several years it is extremely difficult to gain a learning curve to diagnose and how to optimally manage them. Typically, these patients bounce from clinician to clinician only to experience disappointing outcomes, complications, and recurrence or worsening of their presenting symptoms. Based on the landmark research of Mulliken, et al,1-4 a rational classification of pediatric hemangioma and vascular malformations has evolved that should be incorporated into everyone s modern clinical practice. This classification system based on endothelial cell characteristics has removed much of the confusion in terminology that is present in the literature today. Once all clinicians understand and utilize this important classification system, ambiguity and confusion will be removed and all clinicians will speak a common language. Vascular malformations are lesions that present at birth and grow commensurately with the child. Trauma, surgery, hormonal influences caused by birth control pills, puberty, and pregnancy may cause the lesion to expand and grow hemodynamically. Vascular malformations at the histologic level demonstrate no endothelial cell proliferation, contain large vascular channels lined by flat endothelium, have a unilamellar basement membrane, do not incorporate tritiated thymidine into endothelial cells, and have normal mast cell counts. They may be formed from any combination of arterial, capillary, venous, or lymphatic elements with or without direct arterial venous shunts. Vascular malformations are true structural anomalies resulting from incomplete resorption of primitive blood vessels. Work-up of a vascular malformation includes a thorough physical examination with history. Appropriate issues are the time of occurrence of the initial symptoms and
2 whether it was present at birth. Were there issues with regards to hormonal influences? Does the patient have a Nicoladoni-Branham test (whether reflex bradycardia occurs with an inflow arterial occlusion)? Color Doppler imaging is an essential tool in the work up of vascular malformations, particularly with high-flow lesions. Color Doppler imaging is also an important non-invasive method for following patients undergoing treatment. MR has proven to be invaluable in the initial diagnosis and the follow-up management of patients with vascular malformations in all anatomic locations. It is able to distinguish between high-flow and low-flow lesions. Further, it is able to determine the efficacy of therapy at long-term follow up. High-flow lesions include congenital arterial venous malformations, arteriovenous fistula, and acquired vascular lesions as well. Low-flow lesions include venous malformations, lymphatic malformations, capillary venous malformations, and mixed lesions. After the diagnosis is established, the next hurdle is to determine whether therapy is warranted. A vascular malformation team should be in place even though the Interventional Radiologist does primarily plan and direct patient s care. According to D. Emerick Szilagyi, MD, former editor for the Journal of Vascular Surgery,... with few exceptions, their (vascular malformations) cure by surgical means is impossible. We intuitively thought that the only answer of a surgeon to the problem of disfiguring, often noisome, and occasionally disabling blemishes and masses, prone to cause bleeding, pain, or other unpleasantness, was to attack them with vigor and with the determination of eradicating them. The results of this attempt at radical treatment were disappointing. 5 Indeed, of 82 patients seen in this patient series, only 18 were even deemed operable with no therapy offered to the remaining patients. Of the 18 patients operated upon, 10 were improved, 2 remained unchanged, and 6 were worse at follow up. This patient series points to the enormity of the problem posed by vascular malformations. They are best treated in centers where these patients are seen regularly. The Interventional Radiologist who occasionally evaluates a patient every year or so will have difficulty gaining a significant learning curve or have enough experience to manage these challenging lesions. All too frequently, the patient ultimately pays for the Interventional Radiologist s initial enthusiasm, inexperience, folly, and lack of necessary clinical back up. For optimal treatment, a vascular malformation team should be in place. Headed by the Interventional Radiologist, the various surgical and medical specialties function together much like a tumor board team of specialists. When patients are seen and treated regularly, experience can be gained, rational decisions can be made, and patient care is optimized. It cannot be emphasized enough that, as a group, vascular malformations pose one of the most difficult challenges in the practice of medicine. A cavalier approach will always lead to significant complications and dismal patient outcomes. In our treatment of over 400 patients, the vast majority of our patients undergo general anesthesia. In addition, in selected cases, additional Swan-Ganz line
3 monitoring and arterial line may be necessary. Pulmonary artery pressures are constantly monitored during the injection of absolute ethanol. During a procedure we rarely treat patients with greater than 0.5 ml/kg body weight total dose. Depending on how to access the nidus of the high-flow or low-flow lesion will determine if transvascular approaches or direct percutaneous puncture approaches will be utilized. In our practice, patients are treated with 98% ethyl alcohol as the embolic agent. This is our preferred agent of choice. As has been published by several authors, the use of Ethibloc, glue, coils, PVA, etc, is palliative at best. 6 In fact, many authors have reported, not only an incomplete treatment, but also recanalization at follow up.6-9 Our approach is to treat AVM s in a curative fashion, not a palliative fashion. The main reason recanalizations and neovascular recruitment phenomenon occur in AVM management is that all embolic agents do not completely destroy the endothelial cells of the AVM. Only sclerosants, in particular the sclerosant ethanol, does it the best. The endothelial cell, when it is intact during thrombosis, senses decreased oxygen tension and sends out an angiogenesis factor which stimulates neovascular formation. Further, it sends out chemotactic factors that cause a cellular infiltration to carry debris from the vascular channels. Once this occurs, the endothelial cell re-endothelializes and recanalization occurs. With the use of ethanol, the endothelial cell is denuded from the vascular wall, its protoplasm is precipitated, and there is a fracture in the vascular wall to the level of the internal elastic lamina. Because of this destruction of the endothelial cell, the permanence encountered by ethanol in treating vascular malformations is almost routine In over 400 patients, we have been able to cure peripheral arteriovenous malformations at long-term follow up in excess of 2 years and greater than 80% of the time. In arteriovenous fistula, that are congenital and not traumatic, the cure rate at the same mean follow up, is 100%. In acquired arteriovenous fistula, we re able to cure approximately 90% of the time at 2-year mean follow up. The low-flow lesions also demonstrate permanent occlusion at long- term follow up. In the world s published literature, the cure rate for brain AVM with endovascular approaches is less than 5%, and of those that are cured, it is almost always in the Spetzler-Martin grading scale of 1 to 2. The higher-grade lesions, grade 3 to 5, are almost never cured by endovascular means and require additional neurosurgery or surgical extraction to achieve cure. In the series of Frizzel and Frazier, who did a review of the last 35 years of all embolization papers published of brain AVM, a cure rate of 5% was noted.24 In our first paper utilizing ethanol as the embolic agent to treat brain AVM, our cure rate was 47%.25 Currently, our rate is greater than 60% in patients with brain AVM Grade 3, Grade 4, and Grade 5. Conclusion. Thus, we conclude that, at long-term follow up, cure of vascular malformations is a distinct possibility. Acceptable complication rates can occur with the use of ethanol. Patients are best treated in centers that manage these patients regularly. In the endovascular management of vascular malformations, ethanol demonstrates a level of permanence that is seldom encountered by other agents.
4 References 1. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg. 1982;69: Mulliken JB, Zetter BR, Folkman J. In vitro characteristics of endothelium from hemangiomas and vascular malformations. Surgery. 1982; 92: Glowacki J, Mulliken JB. Mast cells in hemangiomas and vascular malformations. Pediatrics. 1982; 70: Finn MC, Glowacki J, Mulliken JB. Congenital vascular lesions: a clinical application of a new classification. J Pediatr Surg. 1983;18: Szilagyi DE, Smith RF, Elliott JP, Hageman JH. Congenital arteriovenous anomalies of the limbs. Arch Surg. 1976;111: Widlus DM, Murray RR, White RI Jr, et al. Congenital arteriovenous malformations: Tailored embolotherapy. Radiology. 1988;169: Rao VRK, Mandalan KR, Gupta AK, et al. Dissolution of isobutyl 2-cyanoacrylate on longterm follow up. AJNR. 1989; 10: Vinter HV, Lundie MJ, Kaufmann JCE. Long-term pathological follow up of cerebral arteriovenous malformations treated by embolizations with bucrylate. N Engl J Med.1986;314: Brothers MF, Kaufmann JCE, Fox AJ, Deveikis JP. N-butyl-2-cyanoacrylate substitute for IBCA in interventional radiology: Histopathologic and polymerization times studies. AJR. 1988; 10: Takebayaski S, Hosaka M, et al. Arteriovenous malformations of the kidneys: Ablation with alcohol. AJR. 1988; 150: Vinson AM, Rohrer DB, Willcox CW, et al. Absolute ethanol embolization for peripheral arteriovenous malformation: Report of two cures. South Med J. 1988;1: Rak KM, Yakes WF, Ray RL, et al. MR imaging of symptomatic peripheral vascular malformations. AJR. 1992; 159: Yakes WF, Pevsner PH, Reed MD, Donohue HJ, Ghaed M. Serial embolizations of an extremity arteriovenous malformation with alcohol via direct percutaneous puncture. AJR. 1986; 146:
5 14. Yakes WF, Haas DK, Parker SH, et al. Symptomatic vascular malformations: Ethanol embolotherapy. Radiology. 1989; 170: Yakes WF, Parker SH, Gibson MD, et al. Alcohol embolotherapy of vascular malformations. Semin Intervent Radiol. 1989; 6: Yakes WF, Luethke JM, Parker SH, et al. Ethanol embolization of vascular malformations. RadioGraphics. 1990; 10: Yakes WF, Luethke JM, Merland JJ, et al. Ethanol embolization of arteriovenous fistulas: a primary mode of therapy. JVIR. 1990;1: Yakes WF, Rossi P, Odink H. How I do it: Ateriovenous malformation management. CVIR. 1996;19: Yakes WF. Discussion of sclerotherapy of head and neck venous malformations. Plast Reconstr Surg. 1999;104: Berenguer B, Burrows PE, Zurakowski D, Mulliken JB. Sclerotherapy of carniofacial venous malformations: complications and results. Plast Reconstr Surg. 1999;104: Berthelsen B, Fogdestam I, Svendsen P. Venous malformation in the face and neck: radiologic diagnosis and treatment with absolute ethanol. Acta Radiol Diag (Stockh.). 1986;27: Svendsen P, Wikholm G, et al. Installation of alcohol into venous malformations of the head and neck. Scand J Plast Reconstr Surg Hand Surg. 1994; 28: Mourao GS, Hodes JE, Gobin YP, Casasco A, Aymard A, Merland JJ. Curative treatment of scalp arteriovenous fistulas by direct puncture and embolization with absolute alcohol. J Neurosurg. 1991; 75: Frizzel RT, Fisher WS. Cure, morbidity, and mortality associated with embolization of brain AVM s: a review of 1246 in 32 series over a 35-year period. Neurosurgery. 1995; 37: Yakes WF, Krauth L, Ecklund J, et al. Ethanol endovascular management of brain AVMs; initial results. Neurosurgery ;40:
Alcohol injections for management of vascular malformations. Clinical case report. Hendro Sudjono Yuwono
Alcohol injections for management of vascular malformations Clinical case report Hendro Sudjono Yuwono Department of Surgery, School of Medicine, Padjadjaran University Bandung, Indonesia Abstract Vascular
More informationHigh-Flow Vascular Malformation of Ear: A Case Report
256 Ear high-flow vascular malformation Case Report High-Flow Vascular Malformation of Ear: A Case Report Ankit Gupta 1*, Shyam Gupta 1, Akhil Kumar 2, Sameek Bhattacharaya 1, Manoj Jha 1, Vinay Tiwari
More informationDUPLEX-GUIDED FOAM SCLEROTHERAPY FOR THE SYMPTOMATIC VENOUS MALFORMATIONS
1 Case Report Title of the article: Duplex-guided Foam Sclerotherapy for the Treatment of the Symptomatic Venous Malformations of the face: Report of A Case Brief title Duplex-guided foam sclerotherapy
More informationTreatment of venous malformations direct injection with ethanol
Treatment of venous malformations direct injection with ethanol by Paula IC Shireman, M_D, Walter J. McCarthy, MD, James S. T. Yao, MD, PhD, and Robert L. Vogelzang, MD, Chicago, Ill. Purpose: Venous malformations
More informationAteriovenous malformations (AVMs) involving the auriculae
ORIGINAL RESEARCH L.Z. Zheng X.D. Fan J.W. Zheng L.X. Su Ethanol Embolization of Auricular Arteriovenous Malformations: Preliminary Results of 17 Cases BACKGROUND AND PURPOSE: Because of the relatively
More informationGLUT-1: an extra diagnostic tool to differentiate between haemangiomas and vascular malformations q
The British Association of Plastic Surgeons (2005) 58, 348 352 GLUT-1: an extra diagnostic tool to differentiate between haemangiomas and vascular malformations q J. Leon-Villapalos a, K. Wolfe b, L. Kangesu
More informationPeripheral Arteriovenous Malformations with a Dominant Outflow Vein: Results of Ethanol Embolization
Peripheral Arteriovenous Malformations with a Dominant Outflow Vein: Results of Ethanol Embolization Sung Ki Cho, MD 1 Young Soo Do, MD 1 Dong Ik Kim, MD 2 Young Wook Kim, MD 2 Sung Wook Shin, MD 1 Kwang
More informationSclerotherapy for Venous Vascular and Lymphatic Malformations
Service: Imaging Sclerotherapy for Venous Vascular and Lymphatic Malformations Exceptional healthcare, personally delivered Your doctor has requested that you have sclerotherapy. We hope that the following
More informationComment je réponds au clinicien qui me demande de classer (selon ISSVA) une tache de naissance?
Comment je réponds au clinicien qui me demande de classer (selon ISSVA) une tache de naissance? Ph. Clapuyt, L. Boon Cliniques universitaires saint Luc Université catholique de Louvain 1200 Bruxelles Les
More information7/5/2016. Neonatal high-output cardiac failure. Case 1 POSTNATAL STRATEGIES FOR CEREBRAL ATERIOVENOUS MALFORMATIONS
John Deveikis, M.D. POSTNATAL STRATEGIES FOR CEREBRAL ATERIOVENOUS MALFORMATIONS JULY, 2016 Neonatal high-output cardiac failure Tachypnea, tachycardia, hypotension, failure to thrive When congenital heart
More informationHamburg Classification: Vascular Malformation
1 2 Hamburg Classification: Vascular Malformation 9 3 Dirk A. Loose and Raul E. Mattassi 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 AU1 Vascular malformations occur
More informationPatients with intralesional hemorrhage in venous malformations: Diagnosis and embolosclerotherapy
Patients with intralesional hemorrhage in venous malformations: Diagnosis and embolosclerotherapy Hui Chen, MD, Xiaoxi Lin, MD, Yunbo Jin, MD, Wei Li, MD, Gang Ma, MD, and Xiaojie Hu, MD, Shanghai, China
More informationTasopoulou KM 1, Argyriou C 1, Mantatzis M 2, Kantartzi K 3, Passadakis P 3, Georgiadis GS 1
Tasopoulou KM 1, Argyriou C 1, Mantatzis M 2, Kantartzi K 3, Passadakis P 3, Georgiadis GS 1 1 Department of Vascular Surgery, 2 Department of Radiology/Interventional Radiology Unit and 3 Department of
More informationSonography of soft-tissue vascular lesions
Sonography of soft-tissue vascular lesions Oscar M. Navarro Associate Professor, University of Toronto Dept. of Diagnostic Imaging, The Hospital for Sick Children Toronto, Canada Declaration of Disclosure
More informationAngiographic features of rapidly involuting congenital hemangioma (RICH)
Pediatr Radiol (2003) 33: 15 19 DOI 10.1007/s00247-002-0726-3 CASE REPORT Orhan Konez Patricia E. Burrows John B. Mulliken Steven J. Fishman Harry P.W. Kozakewich Angiographic features of rapidly involuting
More informationFeatures compression after open and endovascular operation in vascular malformation
Features compression after open and endovascular operation in vascular malformation Sapelkin Sergey Institute of Surgery named A.V. Vishnevsky, Moscow, Russia 21.10.2017 CIRC Meeting, Grassau AV-malformations:
More informationPDF hosted at the Radboud Repository of the Radboud University Nijmegen
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/066/5
More informationWhat Is an Arteriovenous malformation (AVM)?
American Society of Neuroradiology What Is an Arteriovenous malformation (AVM)? From the Cerebrovascular Imaging and Intervention Committee of the American Heart Association Cardiovascular Council Randall
More informationExplaining All of the Options for AVM: Cerebral Arteriovenous Malformation
Explaining All of the Options for AVM: Cerebral Arteriovenous Malformation Recorded on: November 19, 2012 Bernard Bendok, M.D. Director of the Neurointerventional Program Northwestern Memorial Hospital
More informationClinical effects and safety of interventional therapy for parenchyma vascular malformation
Clinical effects and safety of interventional therapy for parenchyma vascular malformation M.J. Cai 1, W.X. Liang 2, W.W. Mai 1, W.L. He 1 and H.X. Kuang 1 1 Department of Radiology, The Third Affiliated
More informationTreatment of Venous Malformations with Ethanolamine Oleate
20 th Congress of AAPS Treatment of Venous Malformations with Ethanolamine Oleate Bijoy Krishna Das 1 and Shafiqul Hoque, 2 1 Department of Paediatric Surgery, Gono-Shasthaya Samaj Vittik Medical College,
More informationTREATMENT OF VENOUS MALFORMATIONS COMPARISON TO LYMPHATIC MALFORMATIONS
139 Lymphology 41 (2008) 139-146 TREATMENT OF VENOUS MALFORMATIONS COMPARISON TO LYMPHATIC MALFORMATIONS M. Schumacher, U. Ernemann, A. Berlis, J. Weber Department of Neuroradiology, University Hospital
More informationEndovascular Treatment of Cerebral Arteriovenous Malformations. Bs. Nguyễn Ngọc Pi Doanh- Bs Đặng Ngọc Dũng Khoa Ngoại Thần Kinh
Endovascular Treatment of Cerebral Arteriovenous Malformations Bs. Nguyễn Ngọc Pi Doanh- Bs Đặng Ngọc Dũng Khoa Ngoại Thần Kinh Stroke Vascular Malformations of the Brain Epidemiology: - Incidence: 0.1%,
More informationSubject Area Modules. Subject Area Modules. Subject Area Modules Published on Society for Vascular Surgery (
Purchasing the VESAP3 comprehensive package provides access to all 10 VESAP3 modules, in learning and exam mode, for $151 less than the cost of purchasing all modules individually. Click here to learn
More informationOvarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome. Original Policy Date
MP 4.01.11 Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome Medical Policy Section OB/Gyn/Reproduction Issue 12:2013 Original Policy Date 12:2013 Last Review Status/Date
More informationVascular Malformations of the Brain. William A. Cox, M.D. Forensic Pathologist/Neuropathologist. September 8, 2014
Vascular Malformations of the Brain William A. Cox, M.D. Forensic Pathologist/Neuropathologist September 8, 2014 Vascular malformations of the brain are classified into four principal groups: arteriovenous
More informationBrain Arteriovenous Malformations Endovascular Therapy and Associated Therapeutic Protocols Jorge Guedes Cabral de Campos
Endovascular Therapy and Associated Therapeutic Protocols Jorge Guedes Cabral de Campos Neuroradiology Department Hospital de Santa Maria University of Lisbon CEREBRAL AVM CLINICAL / EPIDEMIOLOGY Brain
More informationTransarterial Embolisation of Cerebral Arteriovenous Malformations
Transarterial Embolisation of Cerebral Arteriovenous Malformations How Few Can You Do? G. WIKHOLM, C. LUNDQVIST*, P. SVENDSEN Section of Interventional Neuroradiology, Department of Radiology, * Department
More informationCirsoid Aneurysm of the Scalp: a case report
Romanian Neurosurgery Volume XXXI Number 3 2017 July-September Article Cirsoid Aneurysm of the Scalp: a case report Faran Ahmad, Deepak Kumar Singh, Hanuman Prasad Prajapati, Anuj Chhabra INDIA DOI: 10.1515/romneu-2017-0069
More informationRare case of a Congenital Arteriovenous malformation (Park Weber angiodysplasia) around the elbow with median nerve compression
ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 14 Number 1 Rare case of a Congenital Arteriovenous malformation (Park Weber angiodysplasia) around the elbow with median nerve compression S
More informationFrom the American Venous Forum
From the American Venous Forum Predictors of response to percutaneous ethanol sclerotherapy (PES) in patients with venous malformations: Analysis of patient self-assessment and imaging Woo-Sung Yun, MD,
More informationManagement of arteriovenous malformations: A multidisciplinary approach
Management of arteriovenous malformations: A multidisciplinary approach Byung-Boong Lee, MD, PhD, FACS, Y. S. Do, MD, Wayne Yakes, MD, D. I. Kim, MD, Raul Mattassi, MD, and W. S. Hyon, MD, Seoul, Korea
More informationHIGH-FLOW ARTERIOVENOUS MALFORMATION WİTHİN ENLARGED FETAL LEG (Congenital Hemangioma vs Parkes Weber Syndrome)
HIGH-FLOW ARTERIOVENOUS MALFORMATION WİTHİN ENLARGED FETAL LEG (Congenital Hemangioma vs Parkes Weber Syndrome) DORUK CEVDI KATLAN, MD Department of Obstetrics and Gynecology / Perinatology Suleymaniye
More informationMethods. Treatment options for intracranial arteriovenous malformations
AJNR Am J Neuroradiol 25:1139 1143, August 2004 Complete Obliteration of Intracranial Arteriovenous Malformation with Endovascular Cyanoacrylate Embolization: Initial Success and Rate of Permanent Cure
More informationChapter 4 Section 20.1
Surgery Chapter 4 Section 20.1 Issue Date: August 29, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationMP Ovarian and Internal Iliac Vein Embolization as a Treatment of Pelvic Congestion Syndrome
Medical Policy MP 4.01.18 BCBSA Ref. Policy: 4.01.18 Last Review: 08/20/2018 Effective Date: 08/20/2018 Section: OB/GYN Reproduction Related Policies 4.01.11 Occlusion of Uterine Arteries Using Transcatheter
More informationOcclusive hyperemia: a theory for the hemodynamic complications following resection of intracerebral arteriovenous malformations
J Neurosurg 78: 167-175, 1993 Occlusive hyperemia: a theory for the hemodynamic complications following resection of intracerebral arteriovenous malformations NAYEF R. F. AL-RODHAN, M.D., PH.D., THORALF
More informationSclerotherapy after embolization of draining vein: A safe treatment method for venous malformations
Sclerotherapy after embolization of draining vein: A safe treatment method for venous malformations Yunbo Jin, MD, Xiaoxi Lin, MD, Wei Li, MD, Xiaojie Hu, MD, Gang Ma, andmd, Wei Wang, MD, Shanghai, People
More informationRadiographic and statistical analysis of Brain Arteriovenous Malformations.
Radiographic and statistical analysis of Brain Arteriovenous Malformations. Poster No.: C-0996 Congress: ECR 2017 Type: Educational Exhibit Authors: C. E. Rodriguez 1, A. Lopez Moreno 1, D. Sánchez Paré
More informationRecanalization of the Left Common Iliac Vein for MayeThurner Syndrome Associated with Arteriovenous Fistula
EJVES Short Reports (2015) 29, 3e7 SHORT REPORT Recanalization of the Left Common Iliac Vein for MayeThurner Syndrome Associated with Arteriovenous Fistula H. Yuan a, J. Sun b,h.t.qi c, X. Jin a, X.J.
More informationRole of the Radiologist
Diagnosis and Treatment of Blunt Cerebrovascular Injuries NORDTER Consensus Conference October 22-24, 2007 Clint W. Sliker, M.D. University of Maryland Medical Center R Adams Cowley Shock Trauma Center
More informationSupratentorial cerebral arteriovenous malformations : a clinical analysis
Original article: Supratentorial cerebral arteriovenous malformations : a clinical analysis Dr. Rajneesh Gour 1, Dr. S. N. Ghosh 2, Dr. Sumit Deb 3 1Dept.Of Surgery,Chirayu Medical College & Research Centre,
More informationUntangling Cerebral Dural Arteriovenous Fistulas
Untangling Cerebral Dural Arteriovenous Fistulas Bradley A. Gross, MD Assistant Professor, Dept of Neurosurgery, University of Pittsburgh September 2017 davfs Definition Clinical Presentation Natural History
More informationPediatric Neurointervention: Vein of Galen Malformations
Pediatric Neurointervention: Vein of Galen Malformations Johanna T. Fifi, M.D. Assistant Professor of Neurology, Neurosurgery, and Radiology Icahn School of Medicine at Mount Sinai November 9 th, 2014
More informationSoft tissue venous malformations may cause musculoskeletal
ORIGINAL ARTICLE Toe-Walking Attributable to Venous Malformation of the Calf Muscle Benjamin G. Domb, MD,* A. Jay Khanna, MD, * Sally E. Mitchell, MD and Frank J. Frassica, MD* Abstract: Soft tissue venous
More informationTreatment of Slow-Flow (Type I) Perimedullary Spinal Arteriovenous Fistulas with Special Reference to Embolization
AJNR Am J Neuroradiol 26:2582 2586, November/December 2005 Case Report Treatment of Slow-Flow (Type I) Perimedullary Spinal Arteriovenous Fistulas with Special Reference to Embolization Ismail Oran, Mustafa
More informationTreatment of tongue cavernous haemangioma with direct puncture and sclerotization with ethanol
case report 75 Treatment of tongue cavernous haemangioma with direct puncture and sclerotization with ethanol Tomaz Seruga, Jernej Lucev, Marko Jevsek Radiology Department, University Medical Centre Maribor,
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 4,000 116,000 120M Open access books available International authors and editors Downloads Our
More informationCHARACTERIZATION OF CONGENITAL VASCULAR MALFORMATION IN THE EXTREMITIES USING WHOLE BODY BLOOD POOL SCINTIGRAPHY AND LYMPHSCINTIGRAPHY
77 Lymphology 42 (2009) 77-84 CHARACTERIZATION OF CONGENITAL VASCULAR MALFORMATION IN THE EXTREMITIES USING WHOLE BODY BLOOD POOL SCINTIGRAPHY AND LYMPHSCINTIGRAPHY Y.H. Kim, J.Y. Choi, Y.W. Kim, D.I.
More informationTransarterial Embolization of Cerebral Arteriovenous Malformations: Improvement of Results with Experience
Transarterial Embolization of Cerebral Arteriovenous Malformations: Improvement of Results with Experience Gunnar Wikholm, Christer Lundqvist, and Paul Svendsen PURPOSE: To present the treatment outcome
More informationOriginal Article Study on new classification and treatment of vascular malformations in the extremities
Int J Clin Exp Med 2018;11(4):4021-4029 www.ijcem.com /ISSN:1940-5901/IJCEM0072003 Original Article Study on new classification and treatment of vascular malformations in the extremities Xuejian Liu, Hailin
More informationChoosing The Right Size Particle. Gary Siskin, MD FSIR Professor and Chairman Department of Radiology Albany Medical Center Albany, New York
Choosing The Right Size Particle Gary Siskin, MD FSIR Professor and Chairman Department of Radiology Albany Medical Center Albany, New York Gary Siskin, M.D. Consultant/Advisory Board: Boston Scientific,
More informationMASSIVE EPISTAXIS IN A NEONATE: A SYMPTOM OF VEIN OF GALEN MALFORMATION!
CASE REPORT MASSIVE EPISTAXIS IN A NEONATE: A SYMPTOM OF VEIN OF GALEN MALFORMATION! Shagufta Wahab 1, Rizwan Ahmad Khan 2, Manjari Thapa Manger 3 1. Radiodiagnosis, Aligarh Muslim University, Aligarh,
More informationThe Efficacy of Polidocanol foam Sclerotherapy in Treatment of Infantile Hemangioma and Slow-Flow Vascular Malformation
The Efficacy of Polidocanol foam Sclerotherapy in Treatment of Infantile Hemangioma and Slow-Flow Vascular Malformation Suhail Ibraheem Kadhum, B.D.S. (1) Thair Abdul Lateef, B.D.S., H.D.D., F.I.B.M.S.
More informationEthanol Embolotherapy of Pelvic Arteriovenous Malformations: an Initial Experience
Ethanol Embolotherapy of Pelvic Arteriovenous Malformations: an Initial Experience Sooho Bae, MD 1 Young Soo Do, MD 1 Sung Wook Shin, MD 1 Kwang Bo Park, MD 1 Dong-Ik Kim, MD 2 Young Wook Kim, MD 2 Sung
More informationUltrasound of soft-tissue vascular anomalies
Ultrasound of soft-tissue vascular anomalies Oscar M. Navarro Associate Professor, University of Toronto Dept. of Diagnostic Imaging, The Hospital for Sick Children Toronto, Canada Declaration of Disclosure
More informationCatheter Embolization 1
http://www.radiologyinfo.org Catheter Embolization This procedure is reviewed by a physician with expertise in the area presented and is further reviewed by committees from the American College of Radiology
More informationVascular malformations and their management
Information for patients Vascular malformations and their management Introduction This leaflet tells you about the condition known as vascular malformation, including venous malformation, arteriovenous
More informationImaging of Cerebrovascular Disease
Imaging of Cerebrovascular Disease A Practical Guide Val M. Runge, MD Editor-in-Chief of Investigative Radiology Institute for Diagnostic, Interventional, and Pediatric Radiology Inselspital, University
More informationHow varicose veins occur
Varicose veins are a very common problem, generally appearing as twisting, bulging rope-like cords on the legs, anywhere from groin to ankle. Spider veins are smaller, flatter, red or purple veins closer
More information2/2/14 INTRODUCTION. Vascular Anomalies: An Introduction to Classification and Coordination of Care. VASCULAR ANOMALIES: History and Classification
INTRODUCTION Vascular Anomalies: An Introduction to Classification and Coordination of Care Cindy Kerr,RN,MSN,CPNP Erin Spera,RN,MSN,CPNP Mary Beth Sylvia,RN,MS,FNP-BC 1in 3 newborns has a vascular birthmark
More informationMaterials and Methods. A. Biondi, 1 2 J.J. Merland, 1 J.E. Hodes, 1 A. Aymard, 1 and D. Reizine 1
Aneurysms of Spinal Arteries Associated with Intramedullary Arteriovenous Malformations. II. Results of A V M Endovascular Treatment and Hemodynamic Considerations I A. Biondi, 1 2 J.J. Merland, 1 J.E.
More informationEmbolization of Bleeding Pinna Arteriovenous Malformation after Ligation of the External Carotid Artery: A Therapeutic Challenge
184 Case Report THIEME Embolization of Bleeding Pinna Arteriovenous Malformation after Ligation of the External Carotid Artery: A Therapeutic Challenge Rahul Kumar 1 Ankur Goyal 1 Ashu Seith Bhalla 1 Sonia
More informationChapter 4 Section 20.1
Surgery Chapter 4 Section 20.1 Issue Date: August 29, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationVertebral Artery Pseudoaneurysm
Vertebral Artery Pseudoaneurysm T. W. Khanzada,K. R. Makhdoomi ( Department of Vascular Surgery, Liaquat National Postgraduate Medical Centre, Karachi. ) Vertebral artery (VA) pseudoaneurysms are exceedingly
More informationVascular malformations: an update on imaging and management
Review Arch Argent Pediatr 2016;114(2):167-176 / 167 Vascular malformations: an update on imaging and management Sergio Sierre, M.D. a, DaríoTeplisky, M.D. a and José Lipsich, M.D. a a. Department of Interventional
More informationDiagnosis and Management of AVM in the Pregnant Patient
Diagnosis and Management of AVM in the Pregnant Patient Wade Cooper, D.O. University of Michigan Assistant Professor Departments of Neurology & Anesthesiology Disclosures Wade Cooper - None Developmental
More informationHemangiomas and Other Vascular Tumors
facebook.com/cincykidsrad Hemangiomas and Other Vascular Tumors Disclosures No relevant financial disclosures Bernadette L. Koch, M.D. Departments of Radiology and Pediatrics Cincinnati Children s Hospital
More informationInterventional Treatment VTE: Radiologic Approach
Interventional Treatment VTE: Radiologic Approach Hae Giu Lee, MD Professor, Dept of Radiology Seoul St. Mary s Hospital The Catholic University of Korea Introduction Incidence High incidence: 250,000-1,000,000/year
More informationDistinguishing high-flow from low-flow vascular malformations using maximum intensity projection images in dynamic magnetic resonance angiography
Distinguishing high-flow from low-flow vascular malformations using maximum intensity projection images in dynamic magnetic resonance angiography Poster No.: C-2297 Congress: ECR 2016 Type: Scientific
More informationPeripheral vascular malformations (PVMs) are among the most
Diagn Interv Radiol 2011; 17:363 367 Turkish Society of Radiology 2011 INTERVENTIONAL RADIOLOGY ORIGINAL ARTICLE Percutaneous management of peripheral vascular malformations: a single center experience
More informationBrain AVM with Accompanying Venous Aneurysm with Intracerebral and Intraventricular Hemorrhage
Cronicon OPEN ACCESS EC PAEDIATRICS Case Report Brain AVM with Accompanying Venous Aneurysm with Intracerebral and Intraventricular Hemorrhage Dimitrios Panagopoulos* Neurosurgical Department, University
More informationVascular Malformations of the Brain: A Review of Imaging Features and Risks
Vascular Malformations of the Brain: A Review of Imaging Features and Risks Comprehensive Neuroradiology: Best Practices October 27-30, 2016 Sudhakar R. Satti, MD Associate Director Neurointerventional
More informationManagement of the Low-Flow Head and Neck Vascular Malformations in Children: the Sclerotherapy Protocol
Original Article 97 Management of the Low-Flow Head and Neck Vascular Malformations in Children: the Sclerotherapy Protocol Michael Leung 1 Ling Leung 1 Dickson Fung 2 Wai-lun Poon 2 Clarence Liu 1 Kenneth
More informationSDAVFs are rare acquired vascular lesions predominantly
CLINICAL REPORT W.J. van Rooij R.J. Nijenhuis J.P. Peluso M. Sluzewski G.N. Beute B. van der Pol Spinal Dural Fistulas without Swelling and Edema of the Cord as Incidental Findings SUMMARY: SDAVFs cause
More informationChapter 4 Section 20.1
Surgery Chapter 4 Section 20.1 Issue Date: August 29, 1985 Authority: 32 CFR 199.4(c)(2) and (c)(3) 1.0 CPT 1 PROCEDURE CODES 61000-61626, 61680-62264, 62268-62284, 62290-63048, 63055-64484, 64505-64595,
More informationVessel malformation vascular malformation vascular malformation vascular malformation Vascular malformation vascular malformations
A vascular malformation is another type of birthmark, or congenital (present at birth) growth, made up of arteries, veins, capillaries, or lymphatic vessels. There are several different types of malformations
More informationUltrasound imaging of vascular anomalies: pearls and pitfalls
Ultrasound imaging of vascular anomalies: pearls and pitfalls Oscar Navarro, MD Dept. of Medical Imaging, University of Toronto Dept. of Diagnostic Imaging, The Hospital for Sick Children Declaration of
More informationCATHETER REDUCTION. Angelo N. Makris, M.D. Medical Director Chicago Access Care
CATHETER REDUCTION Angelo N. Makris, M.D. Medical Director Chicago Access Care Objectives Discuss tools/techniques proven to improve AVF rates & decrease catheter rates Implement a change process in your
More informationCoronary Arteriovenous Malformation presenting as Acute Myocardial Infarction. Choon Ta NG, Aaron WONG, Foong-Koon CHEAH, Chi Keong CHING
Coronary Arteriovenous Malformation presenting as Acute Myocardial Infarction Choon Ta NG, Aaron WONG, Foong-Koon CHEAH, Chi Keong CHING The patient 49 year old Male presented with Chest tightness x 1
More informationHemangioma of Tongue with Phlebolith: A Rare presentation
Journal of Government Dental College and Hospital, October 2017, Vol.-04, Issue- 01, P. 20-25 Original article: Hemangioma of Tongue with Phlebolith: A Rare presentation 1 Dr. Jigna S Shah (MDS) 1, 2 Dr.
More informationL angiografia ha ancora un ruolo?
Aggiornamenti di Radiologia Interventistica L angiografia ha ancora un ruolo? Roberto Iezzi Dipartimento di Bioimmagini e Scienze Radiologiche Istituto di Radiologia, Policlinico A. Gemelli Università
More informationUrinary tract embolization
Beograd, 14.10.2012 Urinary tract embolization asist. Peter Popovič, MD, MSc Head of abdominal radiology department, Institute of Radiology, UMC Ljubljana Embolization Who and when procedure: local/general
More informationYoung patient with swelling of mandible
HR J Young patient with swelling of mandible, p. 66-71 Clinical Case - Test Yourself Interventional Young patient with swelling of mandible Nikolaos Galanakis 1, Maria Papadaki 2, Dimitrios Tsetis 1 1
More informationEMBOLIZATION OF ARTERIOVENOUS FISTULA AFTER RADIOSURGERY FOR MULTIPLE CEREBRAL ARTERIOVENOUS MALFORMATIONS
Arteriovenous fistula after radiosurgery for multiple CAVM EMBOLIZATION OF ARTERIOVENOUS FISTULA AFTER RADIOSURGERY FOR MULTIPLE CEREBRAL ARTERIOVENOUS MALFORMATIONS Chao-Bao Luo, Wan-Yuo Guo, Michael
More informationAdditional Information S-55
Additional Information S-55 Network providers are encouraged, but not required to participate in the on-line American Venous Forum Registry (AVR) - The First National Registry for the Treatment of Varicose
More informationMultiple Polypoid Angiodysplasia with Obscure Overt Bleeding : A Case report. Jong Pil Im 1, Joo Sung Kim 1. Seoul, Republic of Korea
Multiple Polypoid Angiodysplasia with Obscure Overt Bleeding : A Case report Jooyoung Lee 1, Sung Wook Hwang 1,2, Jihye Kim 1, Jinwoo Kang 1, Gyeong Hoon Kang 3, Kyu Joo Park 4, Jong Pil Im 1, Joo Sung
More informationNeurosurgical decision making in structural lesions causing stroke. Dr Rakesh Ranjan MS, MCh, Dip NB (Neurosurgery)
Neurosurgical decision making in structural lesions causing stroke Dr Rakesh Ranjan MS, MCh, Dip NB (Neurosurgery) Subarachnoid Hemorrhage Every year, an estimated 30,000 people in the United States experience
More informationHistorical perspective
SPINAL AVM Introduction Vascular malformations of spinal cord are a rare clinical entity, representing 5% of all primary spinal cord lesions, with arteriovenous malformations(avm) & cavernous malformations
More informationBY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY
BY Mrs. K.SHAILAJA., M. PHARM., LECTURER DEPT OF PHARMACY PRACTICE, SRM COLLEGE OF PHARMACY Cancer is a group of more than 100 different diseases that are characterized by uncontrolled cellular growth,
More informationTraumatic Arteriovenous Malformation of Cheek: A Case Report and Review of Literature
10.5005/jp-journals-10003-1138 CASE REPORT Traumatic Arteriovenous Malformation of Cheek: A Case Report and Review of Literature Vadisha Srinivas Bhat, Rajeshwary Aroor, B Satheesh Kumar Bhandary, Shama
More informationAbdominal & retroperitoneal endovascular intervention, Bo Kalin, Karolinska Hospital
Abdominal & retroperitoneal endovascular intervention, Bo Kalin, Karolinska Hospital What is endovascular therapy. Diagnosing Traumatic Arterial Injury Clinical signs CT / CT-angiography To diminish a
More informationInterventions for AV-Shunt stenosis: What works best PTA, Stent or DCB?
Interventions for AV-Shunt stenosis: What works best PTA, Stent or DCB? Martin Forlee Vascular Surgeon Cape Town Disclosure Speaker name: Martin Forlee I have the following potential conflicts of interest
More informationDirect percutaneous ethanol instillation for treatment of venous malformation in the face and neck
British Journal of Plastic Surgery (2005) 58, 1073 1078 Direct percutaneous ethanol instillation for treatment of venous malformation in the face and neck Chih-Hsien Lee, Shyi-Gen Chen* Division of Plastic
More informationVascular Surgery Rotation Objectives for Junior Residents (PGY-1 and 2)
Vascular Surgery Rotation Objectives for Junior Residents (PGY-1 and 2) Definition Vascular surgery is the specialty concerned with the diagnosis and management of congenital and acquired diseases of the
More informationFlow-diverting stents (in the Treatment of intracranial aneurysms)
National Hospital for Neurology and Neurosurgery Flow-diverting stents (in the Treatment of intracranial aneurysms) Lysholm Department of Neuroradiology If you would like this document in another language
More informationSurgical Privileges Form: "Neurosurgery" Clinical Privileges Request. Requested (To be completed by the applicant) Not Recommended (For committee use)
Surgical Form: Clinical Request "Neurosurgery" Applicant s Name:. License No. (If Any):... Date:... Scope of Practice:. Facility:.. Place of Work:. the applicant) CATEGORY I: Core : 1. Interpretation of
More informationDECISION MAKING IN AVM TREATMENT STRATEGY TREATMENT BOARD SYSTEM AT TOHOKU UNIVERSITY
Kitakanto Med. J. (S1) : 79-84, 1998 79 DECISION MAKING IN AVM TREATMENT STRATEGY TREATMENT BOARD SYSTEM AT TOHOKU UNIVERSITY Takashi Yoshimoto, Hidefumi Jokura Department of Neurosurgery, Tohoku University
More information24. An infant with recurrent pneumonia underwent a frontal chest radiograph (Fig 24-A) followed by
24. An infant with recurrent pneumonia underwent a frontal chest radiograph (Fig 24-A) followed by diagnosis? ndings, what is the most likely A. Pulmonary sequestration B. Congenital pulmonary airway malformation
More information