ABSTRACT
Background: Central nervous system arteriovenous malformation (AVM) is a vascular malformation of the brain and involves entanglement of veins and arteries without an intervening capillary bed. Affecting predominantly young male patients, AVM presents with different clinical manifestations namely headache, seizures, neurological deficit and intracranial haemorrhage. The patients who present acutely with intracranial bleeding have a significant morbidity and mortality. The aim is to study the angioarchitecture of brain AVM (BAVM) and determine the risk factors for intracranial bleeding. Ultimately, the goal of the study is to look for the association between volume of haematoma and architecture of BAVM. Methods: A cross-sectional study of 58 patients was conducted at the Hospital Universiti Sains Malaysia. Data were collected over a period of seven years (2000 to 2007) to look for the association between the angioarchitecture of brain arteriovenous malformations (BAVM), haemodynamics and the natural history and risk of intracranial haemorrhage. Results: BAVM was predominantly found in young male patients in 65.5%. Small nidal size (P-value=0.004), deep location (P-value=0.003) and deep venous drainage (P-value=0.006) were found to be significant factors contributing to intracranial haemorrhage. All patients with coexisting intranidal or prenidal aneurysms presented with intracranial haematoma. Conclusion: The angioarchitecture of BAVM like nidal size, deep location and deep venous drainage can predict the risk of intracranial bleeding and can help in the management of high risk patients without any delay. Small sized and deep seated lesions have a diffuse type of intracranial bleed which eventually need more attention to the managing team as diffuse haematoma indicates more insult to brain.
ABSTRACT
The fixation, conservation and preservation techniques, with academic and didactic aims, look for the way to find substances that maintain, as far as it is possible, the natural state of the body or organs, permeating the tissues, allowing an easy assembly, providing a detailed information and offering a three-dimensional view of the structures.The objective of the research was the view of angioarchitecture of the human placenta. The samples used were taken from the Servicio de Ginecología y Obstetricia, Unidad de Partos, del Hospital Hernán Enríquez Aravena, de Temuco, IX Región, Chile. All placentas were of a completed gestation condition, of single and normal childbirths.The placentas were injected with hardening solutions, and subject to corrosion with hydrochloric acid 32,4 %. This allowed the creation of a pattern of arteries and veins. Our results confirm that this technique can be useful in teaching and investigation, in view of the low costs and excellent results in the macroscopic visualization of the vascular plot of the human placenta.
Las técnicas de fijación, conservación y preservación, con fines didácticos y académicos, buscan la manera de encontrar sustancias que mantengan, dentro de lo posible, el estado natural del cuerpo u órganos, penetrando en los tejidos y permitiendo un fácil montaje, proporcionando información detallada y una visión tridimensional de las estructuras. Se planteó como objetivo del trabajo la visualización de la angioarquitectura de placenta humana, de gestación a término, partos normales, únicos, perteneciente al Servicio de Ginecología y Obstetricia, Unidad de Partos, del Hospital Hernán Enríquez Aravena, de Temuco, IX Región, Chile. Estas fueron inyectadas a través de los vasos placentarios con resina acrílica autopolimerizable, realizando luego, una corrosión por 11 días con HCL al 32,4 %, siendo hidrolizado completamente el parénquima y el estroma de la placenta, obteniéndose el molde de los vasos. Nuestros resultados confirmaron que esta técnica es útil en docencia e investigación, dado los bajos costos y excelente visualización macroscópica de la trama vascular de la placenta humana.
Subject(s)
Humans , Organ Preservation/methods , Placenta/blood supply , Anatomy/methods , Corrosion CastingABSTRACT
Objective To study the angiographic characteristics of congenital intracranial dural and cerebral arteriovenous malformations, and their relationship to the structural characteristics and clinical feature. Methods The clinical histories, cerebral angiograms, and endovascular treatment of 52 cases of the dural and cerebral arteriovenous malformations were analyzed. Results All 52 patients were treated successfully with interventional therapy with introduction of intravascular emboli through microcatheters. In 2 patients, surgical excision was performed after embolism. In another 4 patients, X-ray knife treatment was carried out. Seventeen patients resumed their work, comprising 44.7% of all patients, and in 16 patients symptoms of epilepsy or head ache were markely improved, comprising 42.1% of the group. Conclusion It is important to study structural characteristics with angiograms for successful treatment of congenital artero-venous anomalies of the brain. [HS(1*2/3]
ABSTRACT
Objective To investigate the angioarchitecture and the efficacy of endovascular embolization of uterine fibroids. Methods Bilateral internal iliac and uterine arteriography were performed to domonstrate the angioarchitecture in uterine fibroids with Seldinger technique. The feeding arteries of uterine fibroids were super-selectively embolized. Results The uterine arteries of 30 patients all originated from the iliac arteries of the ipsilateral side. The feeding arteries of uterine fibroids showed bilateral dominance in 16 cases (53%), unilateral dominance in 11 (37%) and unilateral feeding in only 3(10%). All symptoms disappeared after embolization. The fibroids masses decreased averagely by 40% in size at 3-month with ultrasound follow-up, by 55% at 6 months and by 60% at 12 months with a total clinical efficacy of 100%. Conclusions The key to efficacy and prevention of relapse is to understand the angioarchitecture in order to occlude all the pathological vessels in uterine fibroids.
ABSTRACT
6 cm AVMs(57.1%)were much higher than that with 0.05).Seizure was found in forty-three patients.After embolization the seizure in 20 patients disappeared,11 patients had been improved greatly.The total effective power was 72.1%.Conclusions The size and location of AVM is significantly associated with the onset of seizure.The number of feeding artery has no relation with the seizure.Endovascular embolization for the AVMs has got better cure effect.
ABSTRACT
The goals of embolization of arteriovenous malformations(AVMs) is to reduce the size and decrease the anomalous flow of the vascular malformation to reduce the risk of hemorrhage, so that the curative procedures of surgical resection or radiosurgery can be performed with minimal risk. Endovascular cure rate for AVMs is limited to 5% to 10%, and when some symptomatic relief is desired in a surgically inadvisable AVMs, partial embolization can be performed. In the planning of the managements of AVMs, the thorough interpretation of the angioarchitecture of AVMs is mandatory as not only the natural history of AVMs but also the difficulties and risks of embolization is directly related with it. Hemorrhage from the AVMs is usually related to an associated aneurysm, out flow restriction and pure deep venous drainage. And so the intranidal aneurysm should be obliterated firstly. In the presence of fistulous rapid flow in AVM nidus, the risk of venous side embolic occlusion and resulting hemorrhage is increased. Staged procedure is necessary to avoid rapid hemodynamic changes in regions of chronic ischemia surrounding the AVMs, however delay in definitive treatment allows the recruitment of leptomeningial collaterals and deep perforators, and recanalization of previously embolized pedicle. Recanalization of pre-radiosurgery embolization segment can be a cause of incomplete obliteration after radiosurgery. The management of AVMs is best accomplished by the multimodality treatment that is based on the recognition of these benefits and limits of embolization.
Subject(s)
Aneurysm , Drainage , Hemodynamics , Hemorrhage , Ischemia , Natural History , Radiosurgery , Vascular MalformationsABSTRACT
A study on abdominal skin flaps of the fresh cadavers of young men under the operation, light and scanning electron microscope, and MAS image analysis system has been made. Methods include Chinese ink, ABS or methyl methacrylate injection and histological slides, transparent specimens as well as casts preparation. The course of the vessels in the human abdominal skin flap is in the "three steps form". Trunks and main branches of the cutaneous vessels run in the deep part of the superficial fascia, their branches and terminals form anastomoses in the middle of the reticular layer of dermis, and branches from the anastomoses form microvascular network in the subpapillary layer. The vascular networks in the skin flap are concentrated in five layers: the deep fascial, superficial fascial, profund dermal, subpapillary, and papillary layers. Between the subpapillary and the profund dermal vascular networks, there is a layer devoid of vascular network and crossed by vascular arteries only. Therefore, this layer may be called as "vascular network devoid area". The differences of the area fraction (Aa) or number of vessels are not significant among various areas of the abdominal skin flap. Design in detaching the abdominal skin flaps and skin grafts is discussed.
ABSTRACT
In order to observe the pial and intracortical vessels in the upper and lower lips of calcarine sulcus, the normal human visual cortex of 15 brains (30 sides) were studied with scanning electron microscope (SEM), staining for alkaline phosphatase activity, continuous arterio-venous perfusion and clearing of thick sections according to Malligan's procedure. The results are: (1) Superficial pial arteries on visual cortex originate from calcarine artery, parieto-occipital artery, and inferior posterior temporal artery. Their branches destribute on the surface of the upper and lower lips of the calcarine sulcus resembling a comb. Two types of arterial anastomoses were found. The pial veins of the upper lip of the calcarine sulcus empty into the medial parieto-occipital vein, while those of the lower lip empty mostly into the medial occipital vein. (2) Intracortical arteries might be divided into five groups, i.e, short cortical artery, middle cortical artery, long cortical artery, subcortical artery and medullary artery. In general, they send out forward and recurrent branches. Veins might also be classified into five groups accordingly. There are four layers of vascular network within the striate cortex. The 3rd layer was clearly divided into sublayer 3a, 3b, 3c. The capillary density of the sublayer 3b is with lower density, which is just situated in Gennari's band. Angioarchitecture in the unstriate cortex is loosely arranged. The vascular density of each layer has been measured. The relationship between the blood supply of visual cortex and its clinical significance has been discussed as well.