Infundibular Widening of Angiographically Invisible Duplicate Anterior Choroidal Artery Mimicking Typical Anterior Choroidal Artery Aneurysm

A diagnosis of an intracranial aneurysm depends on the angiographic configuration and should be cautiously differentiated from aneurysm mimics. In cases of duplicate anterior choroidal arteries (AChAs), infundibular widening of the distal minor AChA can be an aneurysm mimic. If the minor AChA with a smaller diameter is obscured angiographically due to poor contrast filling, an associated infundibular widening beside the proximal large AChA can misinterpreted as a typical AChA aneurysm in angiograms. The authors report on two such cases of duplicate AChAs with infundibular widening presenting like a typical AChA aneurysm in angiograms. Surgical exploration revealed a perforating artery emitting from the dome of the saccular lesion, confirming infundibular widening of a duplicate AChA. No reparative procedure was applied to the infundibular widening in a 48-year-old man, while two vascular outpouchings from the infundibular widening were clipped preserving the duplicate AChA in a 55-year-old woman.

How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type / 대한뇌졸중학회지

Background@#and Purpose Previous studies have assessed the relationship between cerebral vessel tortuosity and intracranial aneurysm (IA) based on two-dimensional brain image analysis. We evaluated the relationship between cerebral vessel tortuosity and IA according to the hemodynamic location using three-dimensional (3D) analysis and studied the effect of tortuosity on the recurrence of treated IA. @*Methods@#We collected clinical and imaging data from patients with IA and disease-free controls. IAs were categorized into outer curvature and bifurcation types. Computerized analysis of the images provided information on the length of the arterial segment and tortuosity of the cerebral arteries in 3D space. @*Results@#Data from 95 patients with IA and 95 controls were analyzed. Regarding parent vessel tortuosity index (TI; P<0.01), average TI (P<0.01), basilar artery (BA; P=0.02), left posterior cerebral artery (P=0.03), both vertebral arteries (VAs; P<0.01), and right internal carotid artery (P<0.01), there was a significant difference only in the outer curvature type compared with the control group. The outer curvature type was analyzed, and the occurrence of an IA was associated with increased TI of the parent vessel, average, BA, right middle cerebral artery, and both VAs in the logistic regression analysis. However, in all aneurysm cases, recanalization of the treated aneurysm was inversely associated with increased TI of the parent vessels. @*Conclusions@#TIs of intracranial arteries are associated with the occurrence of IA, especially in the outer curvature type. IAs with a high TI in the parent vessel showed good outcomes with endovascular treatment.

How Cerebral Vessel Tortuosity Affects Development and Recurrence of Aneurysm: Outer Curvature versus Bifurcation Type / 대한뇌졸중학회지

Background@#and Purpose Previous studies have assessed the relationship between cerebral vessel tortuosity and intracranial aneurysm (IA) based on two-dimensional brain image analysis. We evaluated the relationship between cerebral vessel tortuosity and IA according to the hemodynamic location using three-dimensional (3D) analysis and studied the effect of tortuosity on the recurrence of treated IA. @*Methods@#We collected clinical and imaging data from patients with IA and disease-free controls. IAs were categorized into outer curvature and bifurcation types. Computerized analysis of the images provided information on the length of the arterial segment and tortuosity of the cerebral arteries in 3D space. @*Results@#Data from 95 patients with IA and 95 controls were analyzed. Regarding parent vessel tortuosity index (TI; P<0.01), average TI (P<0.01), basilar artery (BA; P=0.02), left posterior cerebral artery (P=0.03), both vertebral arteries (VAs; P<0.01), and right internal carotid artery (P<0.01), there was a significant difference only in the outer curvature type compared with the control group. The outer curvature type was analyzed, and the occurrence of an IA was associated with increased TI of the parent vessel, average, BA, right middle cerebral artery, and both VAs in the logistic regression analysis. However, in all aneurysm cases, recanalization of the treated aneurysm was inversely associated with increased TI of the parent vessels. @*Conclusions@#TIs of intracranial arteries are associated with the occurrence of IA, especially in the outer curvature type. IAs with a high TI in the parent vessel showed good outcomes with endovascular treatment.

Effect of Aluminum Chloride Hemostatic Agent on Bonding Strength of RMGIC in Primary Tooth / 대한소아치과학회지

The purpose of this study was to evaluate the effect of a hemostatic agent containing aluminum chloride on the shear bond strength of resin-modified glass ionomer cement (RMGIC) to the dentin of primary teeth.Thirty-six extracted non-carious human primary teeth were collected in this study. Dentin surfaces were cut and polished. The specimens were randomly divided into 4 groups; group I: RMGIC without conditioning; group II: polyacrylic acid (PAA), RMGIC; group III: aluminum chloride, RMGIC; group IV: aluminum chloride, PAA, RMGIC.All teeth were thermocycled between 5.0℃ and 55.0℃ for 5000 cycles. Fifteen specimens from each group were subjected to shear bond strength test and 3 specimens from each group were inspected using scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy.The mean shear bond strength of each group was as follows: 4.04 ± 0.88 MPa in group I, 8.29 ± 1.40 MPa in group II, 1.39 ± 0.47 MPa in group III, 6.24 ± 2.76 MPa in group IV. There were significant differences among all groups (p In conclusion, aluminum chloride decreased the shear bond strength of RMGIC to dentin, regardless of PAA conditioning.

Difference in Bonding Strength of RMGIC according to Type of Hemostatic Agent in Primary Tooth / 대한소아치과학회지

The purpose of this study was to compare the effect of the hemostatic agent containing aluminum chloride with hemostatic agent containing ferric sulfate on the shear bond strength of resin-modified glass ionomer cement(RMGIC) to dentin in primary tooth.Twenty extracted non-carious human primary teeth were collected in this study. The specimens were cut to expose dentin and polished. The specimens were randomly seperated into 3 groups for treatment; group I: polyacrylic acid(PAA), RMGIC; group II: aluminum chloride, PAA, RMGIC; group III: ferric sulfate, PAA, RMGICTen specimens from each group were subjected to shear bond strength test. The mean shear bond strength of each group was as follows: 10.07 ± 1.83 MPa in Group I, 7.62 ± 0.78 MPA in group II, 5.23 ± 0.78 MPa in group III. There were significant differences among all groups(p In conclusion, both aluminum chloride hemostatic agent and ferric sulfate hemostatic agent decreased the shear bond strength of RMGIC to dentin. And ferric sulfate hemostatic agent decreased the shear bond strength of RMGIC more than the aluminium chloride hemostatic agent.

Effect of Sodium Fluoride Varnish and Potassium Iodide on Remineralization Efficacy of Silver Diamine Fluoride / 대한소아치과학회지

The purpose of this study was to compare the effect of sodium fluoride(NaF) varnish and potassium iodide(KI) on remineralization efficacy of silver diamine fluoride(SDF) by measuring microhardness and evaluating surface morphology by scanning electron microscope(SEM).Artificial caries lesions were induced on extracted primary molars and vickers microhardness was measured. Specimens were randomly separated into 4 groups for treatment. The specimens in group I were treated with SDF, group II with NaF varnish after SDF, group III with KI after SDF and group IV with distilled water. After 8 days of pH cycling, vickers microhardness was measured and difference before and after treatment was calculated. For SEM, 2 samples were evaluated respectively after enamel polishing, lesion formation and after pH cycling.Group III showed highest increase in microhardness. Group I showed higher increase in microhardness than Group II but without statistical difference. Group IV showed lowest increase in microhardness value among 4 groups.On SEM image, group I, II and III showed smoother and less irregular surface compared to group IV. Amorphous crystal pellicles were observed in group III.In conclusion, SDF, SDF and NaF, SDF and KI groups showed smoother surface and increase in microhardness suggesting the possibility that remineralization effect might take place in oral conditions. In addition, in limited conditions of this study, applying NaF varnish after SDF did not increase the remineralization efficacy of SDF while KI significantly increased the remineralization efficacy of SDF. However, additional study considering various conditions that might affect demineralization and remineralization in clinical situations need to be conducted.

Quantification of Vascular Tortuosity by Analyzing Smartphone Fundus Photographs in Patients with Retinopathy of Prematurity

Purpose@#To determine the usefulness of measuring the tortuosity of retinal arteries using smartphone fundus photographs to quantify plus disease in retinopathy of prematurity (ROP) patients. @*Methods@#Digital fundus photographs were taken with a smartphone of 116 eyes involving 58 premature infants. The tortuosity of retinal arteries named as the tortuosity index (TI) was measured with Image J software. Patients were classified into the treated and control groups and the TIs of the two groups were compared. A receiver operating characteristic curve was constructed and areas under the curve (AUC) were calculated to quantify the diagnostic utility of TI. @*Results@#Fundus photographs of 98 eyes of 50 premature infants were analyzed; 38 eyes of 20 infants were the treated group and 60 eyes of 30 infants were the control group. The TI was 1.231 ± 0.156 in the treated group before treatment, which was significantly larger than 1.062 ± 0.019 in the control group. After treatment of the treated group, the TI was 1.100 ± 0.093, which was significantly smaller than before treatment. The AUC was 0.926, and using a cut-off value of 1.095, the sensitivity and specificity of TIs for requiring treatment were 85.1% and 95.5%, respectively. @*Conclusions@#The tortuosity of retinal arteries was measured by analyzing smartphone fundus photographs to quantify plus disease in ROP patients. This method may be helpful for screening, follow-up, and treatment decisions for ROP patients.

Gamma Knife Radiosurgery for ARUBA-Eligible Patients with Unruptured Brain Arteriovenous Malformations

BACKGROUND: A randomized trial of unruptured brain arteriovenous malformations (ARUBA) reported superior outcomes in conservative management compared to interventional treatment. There were numerous limitations to the study. This study aimed to investigate the efficacy of gamma knife radiosurgery (GKS) for patients with brain arteriovenous malformations (AVMs) by comparing its outcomes to those of the ARUBA study. METHODS: We retrospectively reviewed ARUBA-eligible patients treated with GKS from June 2002 to September 2017 and compared against those in the ARUBA study. AVM obliteration and hemorrhage rates, and clinical outcomes following GKS were also evaluated. RESULTS: The ARUBA-eligible cohort comprised 264 patients. The Spetzler-Martin grade was Grade I to II in 52.7% and III to IV in 47.3% of the patients. The mean AVM nidus volume, marginal dose, and follow-up period were 4.8 cm³, 20.8 Gy, and 55.5 months, respectively. AVM obliteration was achieved in 62.1%. The annual hemorrhage rate after GKS was 3.4%. A stroke or death occurred in 14.0%. The overall stroke or death rate of the ARUBA-eligible cohort was significantly lower than that of the interventional arm of the ARUBA study (P < 0.001) and did not significantly differ from that of the medical arm in the ARUBA study (P = 0.601). CONCLUSION: GKS was shown to achieve a favorable outcome with low procedure-related morbidity in majority of the ARUBA-eligible patients. The outcome after GKS in our patients was not inferior to that of medical care alone in the ARUBA study. It is suggested that GKS is rather superior to medical care considering the short follow-up duration of the ARUBA study.

Vaginal sling implant misdiagnosed as rectal subepithelial tumor

As cosmetic procedures receive increasing attention from the media, female genital cosmetic surgery (FGCS) has become quite popular in Korea. The safety and efficacy of these surgeries and procedures have yet to be thoroughly documented. We report a case of a 47-year-old woman who underwent a vaginal sling implantation, which resulted in the misdiagnosis of a rectal subepithelial tumor during endoscopic mucosal resection (EMR). This patient suffered an iatrogenic rectal perforation during the EMR, which necessitated an exploratory operation. The sling implant was removed via the vaginal approach, and a primary repair of the vaginal and rectal walls was performed. The patient subsequently showed no sign of complication at her 6-month follow-up. Patients need to be educated about the importance of reporting a history of FGCS prior to undergoing surgical or endoscopic procedures. Also, physicians have to check the medical history of patient thoroughly to avoid misdiagnoses and unnecessary treatment.

The Pharmacological Inhibition of ERK5 Enhances Apoptosis in Acute Myeloid Leukemia Cells

Acute myeloid leukemia (AML) is a fatal hematological malignancy which is resistant to a variety of chemotherapy drugs. Extracellular signal-regulated kinase 5 (ERK5) plays a novel role in chemoresistance in some cancer cells and this pathway is a central mediator of cell survival and apoptotic regulation. The aim of this study was to investigate the effect of ERK5 inhibitor, XMD8-92, on proliferation and apoptosis in AML cell lines. Findings showed that XMD8-92 inhibited the activation of ERK5 by G-CSF and decreased the expression of c-Myc and Cyclin D1. The treatment of XMD8-92 reduced the phosphorylation of ERK5 leading to a distinct inhibition of cell proliferation and increased apoptosis in Kasumi-1 and HL-60 cells. Taken together, our study suggests that the inhibition of ERK5 by XMD8-92 can trigger apoptosis and inhibit proliferation in AMLs. Therefore, the inhibition of ERK5 may be an effective adjuvant in AML chemotherapy.

Modified Arachnoid Plasty Reduces Chronic Subdural Hematoma after Unruptured Aneurysm Clipping : Technical Note

OBJECTIVE: Chronic subdural hematoma (CSDH) is a rare complication of unruptured intracranial aneurysm (UIA) clipping surgery. To prevent postoperative CSDH by reducing subdural fluid collection, we applied the modified arachnoid plasty (MAP) during the UIA clipping surgery to seal the dissected arachnoid plane.METHODS: This retrospective study included 286 patients enrolled from July 2012 to May 2015. We performed arachnoid plasty in all patients, with MAP used after June 17, 2014. Patients were divided into two groups (non-MAP vs. MAP), and by using uni- and multivariate analyses, baseline characteristics, and relationships with postoperative CSDH between the two groups were analyzed. The degree of preoperative brain atrophy was estimated using the bicaudate ratio (BCR) index.RESULTS: Ten patients (3.5%) among 286 patients had postoperative CSDH after clipping. Nine (3.1%) were in the non-MAP group, and one (0.9%) was in the MAP group. The higher BCR index showed statistical significance with occurrence of postoperative CSDH in both uni- (p=0.018) and multivariate (p=0.012; odds ratio [OR], 8.547; 95% confidence interval [CI], 1.616–45.455) analyses. MAP was associated with a lower risk of postoperative CSDH (p=0.022; OR, 0.068; 95% CI, 0.007–0.683).CONCLUSION: This study shows that the degree of preoperative brain atrophy is associated with an increased occurrence of CSDH after clipping and that MAP could help reduce the risk of postoperative CSDH after unruptured aneurysm clipping via a lateral supraorbital approach.

Treatment Outcomes with Selective Coil Embolization for Large or Giant Aneurysms : Prognostic Implications of Incomplete Occlusion

OBJECTIVE: The objectives of this study were to evaluate the immediate and long-term efficacy and safety of coil embolization for large or giant aneurysms.METHODS: One hundred and fifty large or giant aneurysm cases treated with endovascular coil embolization between January 2005 and February 2014 at a single institute were included in this study. Medical records and imaging findings were reviewed. Statistical analysis was performed to evaluate prognostic factors associated with major recurrence (major recanalization or rupture) and delayed thromboembolism after selective coil embolization.RESULTS: Procedure-related symptomatic complications occurred in five (3.3%) patients. The mean clinical and radiological follow-up periods were 38 months (range, 2–110) and 26 months (range, 6–108), respectively. During the follow-up period, the estimated recurrence rate was 4.6% per year. Multivariate analysis using Cox regression showed the degree of occlusion to be the only factor associated with recurrence (p=0.008, hazard ratio 3.15, 95% confidence interval 1.34–7.41). The patient’s history of rupture in addition to the size and location of the aneurysm were not associated with recurrence in this study. Delayed infarction occurred in eight cases, and all were incompletely occluded.CONCLUSION: Although immediate postprocedural safety profiles were reasonable, longterm results showed recanalization and thromboembolic events to occur continuously, especially in patients with incomplete occlusion. In addition, incomplete occlusion was associated with delayed thromboembolic complications. Patients with incomplete occlusions should be followed carefully for delayed recurrence or delayed thromboembolic events.

Modified Arachnoid Plasty Reduces Chronic Subdural Hematoma after Unruptured Aneurysm Clipping : Technical Note

OBJECTIVE: Chronic subdural hematoma (CSDH) is a rare complication of unruptured intracranial aneurysm (UIA) clipping surgery. To prevent postoperative CSDH by reducing subdural fluid collection, we applied the modified arachnoid plasty (MAP) during the UIA clipping surgery to seal the dissected arachnoid plane. METHODS: This retrospective study included 286 patients enrolled from July 2012 to May 2015. We performed arachnoid plasty in all patients, with MAP used after June 17, 2014. Patients were divided into two groups (non-MAP vs. MAP), and by using uni- and multivariate analyses, baseline characteristics, and relationships with postoperative CSDH between the two groups were analyzed. The degree of preoperative brain atrophy was estimated using the bicaudate ratio (BCR) index. RESULTS: Ten patients (3.5%) among 286 patients had postoperative CSDH after clipping. Nine (3.1%) were in the non-MAP group, and one (0.9%) was in the MAP group. The higher BCR index showed statistical significance with occurrence of postoperative CSDH in both uni- (p=0.018) and multivariate (p=0.012; odds ratio [OR], 8.547; 95% confidence interval [CI], 1.616–45.455) analyses. MAP was associated with a lower risk of postoperative CSDH (p=0.022; OR, 0.068; 95% CI, 0.007–0.683). CONCLUSION: This study shows that the degree of preoperative brain atrophy is associated with an increased occurrence of CSDH after clipping and that MAP could help reduce the risk of postoperative CSDH after unruptured aneurysm clipping via a lateral supraorbital approach.

Treatment Outcomes with Selective Coil Embolization for Large or Giant Aneurysms : Prognostic Implications of Incomplete Occlusion

OBJECTIVE: The objectives of this study were to evaluate the immediate and long-term efficacy and safety of coil embolization for large or giant aneurysms. METHODS: One hundred and fifty large or giant aneurysm cases treated with endovascular coil embolization between January 2005 and February 2014 at a single institute were included in this study. Medical records and imaging findings were reviewed. Statistical analysis was performed to evaluate prognostic factors associated with major recurrence (major recanalization or rupture) and delayed thromboembolism after selective coil embolization. RESULTS: Procedure-related symptomatic complications occurred in five (3.3%) patients. The mean clinical and radiological follow-up periods were 38 months (range, 2–110) and 26 months (range, 6–108), respectively. During the follow-up period, the estimated recurrence rate was 4.6% per year. Multivariate analysis using Cox regression showed the degree of occlusion to be the only factor associated with recurrence (p=0.008, hazard ratio 3.15, 95% confidence interval 1.34–7.41). The patient’s history of rupture in addition to the size and location of the aneurysm were not associated with recurrence in this study. Delayed infarction occurred in eight cases, and all were incompletely occluded. CONCLUSION: Although immediate postprocedural safety profiles were reasonable, longterm results showed recanalization and thromboembolic events to occur continuously, especially in patients with incomplete occlusion. In addition, incomplete occlusion was associated with delayed thromboembolic complications. Patients with incomplete occlusions should be followed carefully for delayed recurrence or delayed thromboembolic events.

Contrast-Induced Acute Kidney Injury after Coil Embolization for Aneurysmal Subarachnoid Hemorrhage

PURPOSE: Contrast-induced acute kidney injury (CI-AKI) is associated with poor outcomes after percutaneous coronary intervention. However, CI-AKI has rarely been evaluated within the neurovascular field. The aim of this study was to investigate the incidence and clinical implication of CI-AKI after coil embolization in patients with an aneurysmal subarachnoid hemorrhage (aSAH). MATERIALS AND METHODS: Between January 2005 and March 2016, 192 patients who underwent coil embolization were enrolled in this study. CI-AKI was defined as an increase from baseline serum creatinine concentration of >25% or >0.5 mg/dL within 72 hours after coil embolization. A poor clinical outcome was defined as a score of ≥3 on the modified Rankin Scale at one-year post-treatment. RESULTS: A total of 16 patients (8.3%) died as a result of medical problems within one year. CI-AKI was identified in 14 patients (7.3%). Prominent risk factors for one-year mortality included CI-AKI [odds ratio (OR): 16.856; 95% confidence interval (CI): 3.437–82.664] and an initial Glasgow Coma Scale (GCS) score ≤8 (OR: 5.565; 95% CI: 1.703–18.184). A poor clinical outcome was associated with old age (≥65 years) (OR: 7.921; 95% CI: 2.977–21.076), CI-AKI (OR: 11.281; 95% CI: 2.138–59.525), an initial GCS score ≤8 (OR 31.02; 95% CI, 10.669–90.187), and a ruptured aneurysm (p=0.016, OR: 4.278) in posterior circulation. CONCLUSION: CI-AKI seems to be an independent predictor of the overall outcomes of aSAH after endovascular treatment.

Pure Subdural Hemorrhage Caused by Internal Carotid Artery Dorsal Wall Aneurysm Rupture

A 37-year-old woman was admitted to our hospital with altered mentality. The patient was diagnosed an internal carotid artery (ICA) dorsal wall aneurysm leading to acute subdural hemorrhage (SDH) without occurring subarachnoid hemorrhage and/or internal parenchymal hemorrhage. An aneurysmal neck clipping and hematoma evacuation were performed at once. A pure SDH by ruptured aneurysm is unusual, but it is important to consider it if a SDH patient has no other medical history.

Predictor and Prognosis of Procedural Rupture during Coil Embolization for Unruptured Intracranial Aneurysm

OBJECTIVE: The objectives of this study was to determine the incidence and outcomes of procedural rupture (PR) during coil embolization of unruptured intracranial aneurysm (UIA) and to explore potential risk factors. METHODS: This retrospective study evaluated 1038 patients treated with coil embolization between January 2001 and May 2013 in a single tertiary medical institute. PR was defined as evidence of rupture during coil embolization or post procedural imaging. The patient's medical records were reviewed including procedure description, image findings and clinical outcomes. RESULTS: Twelve of 1038 (1.1%) patients showed PR. Points and time of rupture were parent artery rupture during stent delivery (n=2), aneurysm rupture during filling stage (n=9) and unknown (n=1). Two parent artery rupture and one aneurysm neck rupture showed poor clinical outcomes [modified Rankin Scale (mRs) >2] Nine aneurysm dome rupture cases showed favorable outcomes (mRS < or =2). Location (anterior cerebral artery) of aneurysm was associated with high procedural rupture rate (p<0.05). CONCLUSION: The clinical course of a patientwith procedural aneurysm rupture during filling stage seemed benign. Parent artery and aneurysm neck rupture seemed relatively urgent, serious and life threatening. Although the permanent morbidity rate was low, clinicians should pay attention to prevent PR, especially when confronting the anterior cerebral artery aneurysm.

Recurrent Bleeding in Hemorrhagic Moyamoya Disease : Prognostic Implications of the Perfusion Status

OBJECTIVE: Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. METHODS: This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. RESULTS: Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate 5.8+/-1.4%/year). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). CONCLUSION: Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.

Transvenous Coil Embolization for Dural Arteriovenous Fistulas of the Ophthalmic Sheath: Report of Two Cases and Review of the Literature

We present two patients with a dural arteriovenous fistula (dAVF) of the ophthalmic sheath who developed progressive exophthalmos, conjunctival chemosis, and visual loss. These symptoms mimic those of cavernous sinus dAVFs. Dural AVFs of the ophthalmic sheath are extremely rare and their clinical management is controversial. We successfully treated these two patients by transvenous coil embolization. Transvenous embolization appears to be a safe and effective method to treat dAVFs of the ophthalmic sheath.

Uterine arteriovenous malformation with positive serum beta-human chorionic gonadotropin: Embolization of both uterine arteries and extra-uterine feeding arteries

The incidence of uterine arteriovenous malformation (AVM) is rare. However, it is clinically significant in that it can cause life-threatening vaginal bleeding. We report a case of a large uterine AVM with positive serum beta-human chorionic gonadotropin. A presumptive diagnosis was made; a uterine AVM accompanied by, early pregnancy or retained product of conception. Because this uterine AVM was extensive, transcatheter arterial embolization of both uterine arteries and extra-uterine feeding arteries was performed. Three months after undergoing transcatheter arterial embolization, complete resolution of the uterine AVM was confirmed without major complication.