ABSTRACT
OBJECTIVE: To evaluate the safety and efficacy of the coil-protected technique for liquid embolization in neurovascular malformations. MATERIALS AND METHODS: Twenty-two patients who underwent coil-protected liquid embolization for symptomatic cranial (n = 13) and spinal (n = 9) arteriovenous fistula (AVF) or arteriovenous malformations (AVMs) were identified. A total of 36 target feeder vessels were embolized with N-butyl cyanoacrylate and/or Onyx (Medtronic). This technique was used to promote delivery of a sufficient amount of liquid embolic agent into the target shunt or nidus in cases where tortuous feeding arteries preclude a microcatheter wedging techniqu and/or to prevent reflux of the liquid embolic agent in cases with a short safety margin. The procedure was considered technically successful if the target lesion was sufficiently filled with liquid embolic agent without unintentional reflux. Angiographic and clinical outcomes were retrospectively evaluated. RESULTS: Technical success was achieved for all 36 target feeders. Post-embolization angiographies revealed complete occlusion in 16 patients and near-complete and partial occlusion in three patients each. There were no treatment-related complications. Of the six patients who showed near-complete or partial occlusion, five received additional treatments: two received stereotactic radiosurgery for cerebral AVM, two underwent surgical removal of cerebral AVM, and one underwent additional embolization by direct puncture for a mandibular AVM. Finally, all patients showed complete (n = 19) or near-complete (n = 3) occlusion of the target AVF or AVM on follow-up angiographies. The presenting neurological symptoms improved completely in 15 patients (68.2%) and partially in seven patients (31.8%). CONCLUSION: The coil-protected technique is a safe and effective method for liquid embolization, especially in patients with various neurovascular shunts or malformations who could not be successfully treated with conventional techniques.
Subject(s)
Humans , Angiography , Arteries , Arteriovenous Fistula , Arteriovenous Malformations , Cyanoacrylates , Follow-Up Studies , Methods , Punctures , Radiosurgery , Retrospective StudiesABSTRACT
Resumen: Las fístulas carótido- cavernosas (FCC) son derivaciones vasculares que permiten el flujo de sangre desde la arteria carótida al seno cavernoso; pueden producir síntomas en ambos sexos a cualquier edad. Algunas fístulas se caracterizan por una conexión directa entre el segmento cavernoso de la arteria carótida interna y el seno cavernoso. Otras FCCs son durales, y consisten en una comunicación entre el seno cavernoso y una o más ramas meníngeas de la arteria carótidainterna, la arteria carótida externa , o ambas. La terapia endovascular es la modalidad de elección en estos casos.Se presenta el uso de N-butilcianoacrilato (NBCA) en una exitosaembolización transarterial de una FCC dural alimentada por ramas de las arterias carótida interna y principalmente carótida externa (Barrow tipo D) en un niño de 1 año.
Abstract:Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery into the cavernous sinus; they can produce symptoms in both sexes at any age. Some fistulas are characterized by a directconnection between the cavernous segment of the internal carotid artery and the cavernous sinus, other CCFs are dural, consisting of a communicationbetween the cavernous sinus and 1 or more meningeal branches of the internal carotid artery, the external carotid artery, or both. Endovascular management is the treatment modality of choice in these cases.We report the use of n-butilcianoacrilate (NBCA) in the successful transarterial embolization of a dural CCF fed by arterial branches of the internal but principally external carotid arteries (Barrow type D)in a 1 year old child.
Resumo: As fístulas carotídeas-cavernosas (FCC) são pistas vasculares que permitem o fluxo sanguíneo da artéria carótida para o seio cavernoso; pode produzirsintomas em ambos os sexos em qualqueridade. Algumas fístulas são caracterizadas por umaconexãodireta entre o segmento cavernoso da artéria carótida interna e o seio cavernoso. OutrosFCCssãodural, consistindo em umacomunicação entre o seio cavernoso e umoumais ramos meníngeos da artéria carótida, a artéria carótida externa ou ambos. A terapia endovascular é o modo de escolhanesses casos. É apresentado o uso de n-butilcianoacrilato (NBCA) em umaembolizaçãotransarterialbem sucedida de uma FCC dural alimentada por ramos das artérias carótidas internas e principalmente artéria carótida externa (tipo Barrow D) em um menino de 1 ano de idade.
ABSTRACT
Objective To investigate nursing cooperation during gastric coronary vein embolization procedure with NBCA glue. Methods Perioperative nuusing experience in 36 hepatic cirrhosis patients complicated with esophagus-gastric fundus vein varicose rupture and hemorrhea who had undergone gastric coronary vein embolization procedure was retrospectively summarized. Results Operations in all 36 cases had been successful,with no severe complication due to inadequate nursing cooperation. Conclusions Gastric coronary vein embolization operation utilizing NBCA glue is a safe and effective method of hemostasis,skilled and elaborative nursing cooperation is an important component ensuring a smooth and effective operation.
ABSTRACT
Objective To study clinical therapeutic effect of endovascular embolization on cerebral arteriovenous malformation(cAVM). Methods In digital subtraction angiography (DSA), 23 patients suffering from cAVM were treated by endovascular embolization with NBCA through microduct technique. 6 cases were embolizated only one time, and 17 cases more than one time. 11 patients were treated with gamma knife after embolization. Results Among 23 patients, 6 cases of cAVM were embolizated completely, 4 cases more than 95%, 9 cases 75% to 95%, and 4 cases less than 70%. 3 patients occurred dizziness and headache after embolization. All patients were followed up after treatment, 4 cases had seizure, and the others' symptoms were obviously improved. Conclusion Endovascular embolization was a safe and effective method for treating cAVM, and combination of embolization and gamma knife could improve the clinical efficiency.