Brain arteriovenous malformation treatment with transvenous endovascular technique after transarterial technique failure
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Abstract
Arteriovenous malformations (AVMs) are unnatural connections in the vascular system. The treatment strategies are dictated by the angioarchitecture, location and presentation of AVMs. The present study sought to report a case report of a 35-year-old female patient diagnosed with a brain AVM and submitted to a transvenous AVM embolization, located at the corpus callosum's splenium, after a previous transarterial embolization failure. As a therapeutic approach, the patient was submitted to transarterial embolization. However, the procedure was performed too proximally in the arteries, which resulted in the total AVM persistency. The patient was submitted to angiographic control until complete AVM occlusion.
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References
National Institute of Neurological Disorders and Stroke (NINDS). Arteriovenous Malformation Information Page. Retrieved Nov 16, 2019, from https://www.ninds.nih.gov/Disorders/All-Disorders/Arte riovenous-Malformation-Information-Page.
Abecassis IJ, Xu DS, Batjer HH, Bendok BR. Natural history of brain arteriovenous malformations: a systematic review. Neurosurg Focus. 2014 Sep;37(3):E7. doi: 10.3171/2014.6. FOCUS14250.
Rustam Al-Shahi, Charles Warlow. A systematic review of the frequency and prognosis of arteriovenous malformations of the brain in adults. Brain, Volume 124, Issue 10, October 2001. Pages 1900–1926. doi:10.1093/brain/124.10.1900.
Benjamin M. The utility of neuroimaging in the evaluation of headache in patients with normal neurologic examinations. Frishberg Neurology. Jul 1994, 44 (7) 1191. doi: 10.1212/WNL.44.7.1191.
Redekop G, TerBrugge K, Montanera W, Willinsky R. Arterial aneurysms associated with cerebral arteriovenous malformations: classification, incidence, and risk of hemorrhage. J Neurosurg. 1998 Oct;89(4):539-46. doi: 10.3171/jns.1998.89.4.0539.
Kim H, Su H, Weinsheimer S, Pawlikowska L, Young WL. Brain arteriovenous malformation pathogenesis: a response-to-injury paradigm. Acta Neurochir Suppl. 2011; 111:83-92. doi:10.1007/978-3-7091-0693-8_14.
Chen CJ, Norat P, Ding D, Mendes GAC, Tvrdik P, Park MS, Kalani MY. Transvenous embolization of brain arteriovenous malformations: a review of techniques, indications, and outcomes. Neurosurg Focus. 2018 Jul;45(1):E13. FOCUS 18113. doi: 10.3171/2018.3.
Conger JR, Ding D, Raper DM, Starke RM, Durst CR, Liu KC, Jensen ME, Evans AJ. Preoperative Embolization of Cerebral Arteriovenous Malformations with Silk Suture and Particles: Technical Considerations and Outcomes. J Cerebrovasc Endovasc Neurosurg. 2016 Jun;18(2):90-99. doi: 10.7461/jcen.2016.18.2.90.
Saatci I, Geyik S, Yavuz K, Cekirge HS. Endovascular treatment of brain arteriovenous malformations with prolonged intranidal Onyx injection technique: long-term results in 350 consecutive patients with completed endovascular treatment course. J Neurosurg. 2011 Jul;115(1):78-88. doi: 10.3171/2011.2. JNS 09830.
Morgan MK, Davidson AS, Assaad NNA, Stoodley MA. Critical review of brain AVM surgery, surgical results and natural history in 2017. Acta Neurochir (Wien). 2017 Aug;159(8):1457-1478. doi: 10.1007/s00701-017-3217-x.
Ramírez-Senent B, Abadal JM, Vázquez E, Lago I, Gálvez E, Araujo MA, de la Quintana MI. Endovascular Management of a Giant High-Flow Lower Limb Arteriovenous Malformation. Vasc Endovascular Surg. 2017 Nov;51(8):572-576. doi: 10.1177/1538574417731206.
Massoud TF. Transvenous retrograde nidus sclerotherapy under controlled hypotension (TRENSH): hemodynamic analysis and concept validation in a pig arteriovenous malformation model. Neurosurgery. 2013 Aug;73(2):332-42; discussion 342-3. doi:10.1227/01.neu.0000430765.80102.77.
Murayama Y, Massoud TF, Viñuela F. Transvenous hemodynamic assessment of experimental arteriovenous malformations. Doppler guidewire monitoring of embolotherapy in a swine model. Stroke. 1996 Aug;27(8):1365-72. doi: 10.1161/01.str.27.8.1365.
Akmangit I, Daglioglu E, Kaya T, Alagoz F, Sahinoglu M, Peker A, Derakshani S, Dede D, Belen D, Arat A. Preliminary experience with squid: a new liquid embolizing agent for AVM, AV fistulas and tumors. Turk Neurosurg. 2014;24(4):565-70. doi: 10.5137/1019-5149.JTN.11179-14.0.