Spinal dural arteriovenous fistulae associated with perimedullary arteriovenous fistulae: imaging characteristics and surgical treatment / 中华外科杂志

<p><b>OBJECTIVE</b>To enhance the clinical doctors' cognizance of atypical spinal dural arteriovenous fistulae (SDAVFs) associated with perimedullary anteriovenous fistulae (PMAVFs).</p><p><b>METHODS</b>The clinical imaging and surgical therapy of 3 patients with PMAVFs were analyzed retrospectively.</p><p><b>RESULTS</b>The clinical presentations of the 3 patients were not significantly different from those of typical SDAVFs. They were verified by repeated spinal angiography that the anterior spinal artery (ASA) is supplied to the drainage-vein. The 3 patients were treated surgically. First two operations were performed to eliminate the supply of ASA and dural branch, then the supply of the dural branch was amputated, and finally both the ASA and dural branch supplies were excised successfully. Clinical symptoms of the 3 patients were improved after treatment.</p><p><b>CONCLUSIONS</b>It is necessary to perform thorough spinal angiography in patients with SDAVFs to exclude another fistula. The key point in the treatment of such patients is successfully to terminate both the spinal feeder and dural branch feeder.</p>

Three dimensional digital subtraction angiography in volume embolization ratio measurement of densely packing experimental aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To calculate the volume embolization ratio of densely packing experimental aneurysms by three dimensional digital subtraction angiography (3D-DSA).</p><p><b>METHODS</b>Six experimental crotch aneurysms were created microsurgically in the common carotid artery of white rabbits. Two weeks later, each aneurysm's volume was measured with 3D-DSA surface shaded display(SSD) and the correction of lacteprene balloon calibration method. In the same time, the aneurysms were densely packed with electric detachable coils. The volume of coils that were used in each aneurysm was calculated separately. The ratio of coils volume and aneurysm volume was the volume embolization ratio (VER).</p><p><b>RESULTS</b>The aneurysms volumes measured by 3D DSA SSD ranged from 0.037 to 0.087 ml. The VER ranged from 23.5% to 32.5% (average 27.4%).</p><p><b>CONCLUSION</b>The minimum VER of densely packing experimental crotch aneurysms with electronic detachable coils was 23.5%.</p>

Experience with transluminal stent-assisted angioplasty for intracranial vascular diseases / 中华外科杂志

<p><b>OBJECTIVE</b>To assess the value of stent-assistant angioplasty for intracranial vascular diseases.</p><p><b>METHODS</b>Thirteen patients with intracranial vascular diseases were treated consecutively by stent-assistant angioplasty for different purposes. Of these patients 7 had symptomatic intracranial artery stenosis, 3 intracranial wide-neck aneurysms, 2 intracranial pseudoaneurysms, and 1 bilateral transverse sinus stenosis. Clinical procedures and technical data of the patients were retrospectively analyzed.</p><p><b>RESULTS</b>In the 7 patients, the degree of intracranial artery stenosis reduced from 83% to 5%. Three months after the operation they exhibited good patency of stented lesions. Intracranial wide neck aneurysms (with 2 pseudoaneurysms) were successfully embolized with GDC in 5 patients. The patients with bilateral transverse sinus stenosis were implanted a self-expanded stent in the right transverse sinus. One patient failed because of the tortuous configuration of the left jugular bulb, but the patient's symptoms were improved quickly after the procedure.</p><p><b>CONCLUSION</b>Stent-assistant angioplasty is a useful technique for selected intracranial vascular diseases, and it needs further investigation.</p>