Browse
Submit Data
Databases
API
Help

Dataset Information

0 Views

0 Connections

0 Citations

0 Reanalyses

0 Downloads

Omics score: 0

Transvenous retrograde embolization of ruptured brain arteriovenous malformations: A case report and review of the literature.

ABSTRACT: Hemorrhagic stroke due to ruptured brain arteriovenous malformations (AVMs) is a common cause in young stroke patients. When the ruptured AVMs are in deep location, the choice of endovascular intervention with the arterial approach to AVM embolization is routine but in many cases, it is not feasible due to the inability to access because of the small and tortuous arterial branch, however, the intravenous approach also results in high complete obliteration rates but also carries a higher risk of stroke than the intra-arterial route. We describe a 36-year-old female patient diagnosed with intracranial and intraventricular hemorrhage who underwent complete transvenous embolization of the ruptured AVMs, and achieved near-complete clinical recovery after 1 month with the modified Rankin scale 1.

SUBMITTER: Tran AT

PROVIDER: S-EPMC8633821 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Json Xml

Publications

Transvenous retrograde embolization of ruptured brain arteriovenous malformations: A case report and review of the literature.

Tran Anh Tuan AT Mai Duy Ton DT Huyen Nguyen Thi NT Đào Viet Phương VP Phung Dinh Tho DT Pham Quang Tho QT

Radiology case reports 20211125 2

Hemorrhagic stroke due to ruptured brain arteriovenous malformations (AVMs) is a common cause in young stroke patients. When the ruptured AVMs are in deep location, the choice of endovascular intervention with the arterial approach to AVM embolization is routine but in many cases, it is not feasible due to the inability to access because of the small and tortuous arterial branch, however, the intravenous approach also results in high complete obliteration rates but also carries a higher risk of ...[more]

PMID: 34876954

Similar Datasets

Outcome of early versus late primary embolization in ruptured brain arteriovenous malformations.

Project description:PurposeTo determine whether patients with a ruptured brain arteriovenous malformation (rBAVM) would benefit from an early embolization.MethodsrBAVM treated first by embolization between March 2002 and May 2022 were included. Embolization was defined early (Group 1) when performed within 10 days postbleeding. If later, embolization was considered late (Group 2). Demographic and rBAVM data were compared between the groups. High-risk bleeding components and reasons for deferring embolization were retrieved. Primary endpoint was rebleeding. Secondary endpoints were good functional outcome (FO, modified Rankin Scale mRS ≤ 2) and angiographic occlusion. Predictors of rebleeding and FO were determined by multivariate analysis.Results105 patients were recruited (N = 34 in Group 1; N = 71 in Group 2). No rebleeding was noted before, during or after the first embolization session in the early embolization group. Late embolization depended on missed diagnosis and referral pattern. Eleven patients (10.5%) suffered a rebleeding, of whom N = 3 before embolization (only in Group 2), N = 5 periembolization (N = 2 at the second embolization session in Group 1) and N = 3 spontaneous more than 30 days postembolization. More high-risk components were embolized in Group 1 (19/34; 55.9 vs 17/71; 23.9%; p = .011). Rebleeding rates, FO at last FU (90.9% vs 74.3%) and occlusion rates (80.8% vs 88.5%) did not differ between the groups. Glasgow coma scale ≤ 8 predicted rebleeding, rebleeding correlated with poor FO.ConclusionEarly embolization did prevent rebleeding. The overall rebleeding risk was linked to bleeding before late embolization and bleeding at the second embolization. Rebleeding predicted the final FO.

| S-EPMC11569778 | biostudies-literature

Vascular stability of brain arteriovenous malformations after partial embolization.

Project description:IntroductionBrain arteriovenous malformation (bAVM) might have a higher risk of rupture after partial embolization, and previous studies have shown that some metrics of vascular stability are related to bAVM rupture risk.ObjectiveTo analyze vascular stability of bAVM in patients after partial embolization.MethodsTwenty-four patients who underwent partial embolization were classified into the short-term, medium-term, and long-term groups, according to the time interval between partial embolization and surgery. The control group consisted of 9 bAVM patients who underwent surgery alone. Hemodynamic changes after partial embolization were measured by angiogram. The inflammatory infiltrates and cell-cell junctions were evaluated by MMP-9 and VE-cadherin. At the protein level, the proliferative and apoptotic events of bAVMs were analyzed by immunohistochemical staining of VEGFA, eNOS, and caspase-3. Finally, neovascularity and apoptotic cells were assessed by CD31 staining and TUNEL staining.ResultsImmediately after partial embolization, the blood flow velocity of most bAVMs increased. The quantity of MMP-9 in the medium-term group was the highest, and VE-cadherin in the medium-term group was the lowest. The expression levels of VEGFA, eNOS, and neovascularity were highest in the medium-term group. Similarly, the expression level of caspase-3 and the number of apoptotic cells were highest in the medium-term group.ConclusionThe biomarkers for bAVM vascular stability were most abnormal between 1 and 28 days after partial embolization.

| S-EPMC10915995 | biostudies-literature

Targeted Embolization of Aneurysms Associated With Brain Arteriovenous Malformations at High Risk for Surgical Resection: A Case-Control Study.

Project description:BackgroundHigh-risk components of brain arteriovenous malformations (BAVMs) can be targeted to reduce the risk of lesion rupture.ObjectiveTo evaluate targeted embolization of aneurysms against other means of treatment with a case-control analysis; we previously investigated this approach associated with BAVMs.MethodsRetrospective analysis of patients with BAVMs was performed, identifying patients treated with intention to occlude only an aneurysm associated with a BAVM. For each targeted aneurysm embolization (TAE) patient identified, 4 control patients were randomly selected, controlling for rupture status, age, and Spetzler-Martin plus Lawton-Young supplemental score. Analysis was performed to compare rates of adverse events (hemorrhage, new seizure, and death) between the 2 groups.ResultsThirty-two patients met inclusion criteria, and 128 control patients were identified, out of 1103 patients treated during the study period. Thirty-four adverse events occurred (15 ruptures, 15 new seizures, and 11 deaths) during the follow-up period (mean 1157 d for the TAE cohort and 1036 d for the non-TAE cohort). Statistically lower associations were noted for the TAE group for any adverse event (hazard ratio 0.28, P = .037) and the composite outcome of hemorrhage or new seizure (hazard ratio 0.20, P = .029).ConclusionFor BAVMs at high risk for surgical resection, TAE can be performed safely and effectively. Patients treated with TAE had better outcomes than matched patients undergoing other combinations of treatment. TAE can be considered for BAVMs with high operative risk prior to radiosurgery or when no other treatment options are available.

| S-EPMC5640504 | biostudies-literature

Contrast-Enhanced Magnetic Resonance Imaging Suggested a Possibility of Transvenous Embolization in the Superior Petrosal Sinus Dural Arteriovenous Fistula: A Case Report.

Project description:ObjectiveSuperior petrosal sinus dural arteriovenous fistula (SPS-DAVF) is a rare subtype of intracranial DAVF that sometimes leads to hemorrhagic symptoms following deep venous drainage. Here we report the case of SPS-DAVF with retrograde venous reflux to the cerebellar vein. Preoperative contrast-enhanced MRI was a decisive factor in a safe and effective treatment.Case presentationA 37-year-old woman was referred to our hospital with abnormal MRI findings, which was performed when she had a mild headache during her check-up. DSA revealed left-sided SPS-DAVF, which was diagnosed as Cognard type IIb. Both CTA and DSA could not detect the whole SPS but only the shunt pouch. Using contrast-enhanced MRI, we were able to visualize the presence of the SPS and its continuity within the shunt pouch. 3D-T1 turbo spin echo (SPACE) showed a low-intensity area in the SPS, which was not seen in the 3D-T1 fast field echo (FFE). During the procedure, there was a point where it was difficult to advance the microcatheter, which coincided with the low-intensity area. We achieved effective transvenous embolization from the occluded venous access by devising a surgical technique.ConclusionIn addition to the contrast-enhanced 3D-T1 FFE, 3D-T1 SPACE might provide beneficial information for endovascular therapy in the evaluation of venous sinuses, which could not be detected by standard examinations.

| S-EPMC10370784 | biostudies-literature

Coil embolization for ruptured coronary pseudoaneurysm causing haemopericardium: a case report.

Project description:BackgroundCoronary artery pseudoaneurysm is a rare disease that can rupture and cause haemopericardium. It can occur principally as a complication after coronary artery instrumentation, but it can also result from trauma.Case summaryA 15-year-old male patient with a history of spontaneous pneumothoraces treated twice with video-assisted thoracoscopic thoracic surgery presented with pericarditis and increasing haemopericardium. During the hospitalization, he had developed cardiogenic shock and he underwent emergent pericardiocentesis. Coronary angiography revealed a small right coronary artery pseudoaneurysm. We successfully coil embolized the pseudoaneurysm.DiscussionThis is a rare case of a ruptured coronary artery pseudoaneurysm associated with prior tube thoracostomy. The treatments for a coronary pseudoaneurysm should be tailored based on the pathologic and anatomical characteristics.

| S-EPMC8189297 | biostudies-literature

Vascular Plug Embolization of a Superior Mesenteric Arteriovenous Fistula: Case Report and Literature Review of Endovascular Treatment.

Project description:IntroductionArteriovenous fistula (AVF) rarely occurs in the portal venous system. Aetiologies include iatrogenic, surgical, and penetrating trauma of the abdomen. Clinical manifestations of superior mesenteric portal arteriovenous fistula (SMPAVF) are right heart failure, mesenteric ischaemia, or signs of portal hypertension.ReportThe case of a 42 year old man with a history of Crohn's disease who had a delayed symptomatic mesenteric portal AVF, occurring 20 years after ileocecal resection, which was subsequently managed by endovascular approach is reported. The patient presented with post-prandial abdominal pain for almost one year, and dyspnoea New York Heart Association stage II. There were no signs of portal hypertension. Pre-operative contrast enhanced computed tomography showed a high flow SMPAVF, with a short and wide neck (9 mm × 16 mm) at the level of the last collateral of the superior mesenteric artery. It was associated with a large aneurysm of the mesenteric vein. Vascular plug embolisation (Amplatzer 18 × 18 mm, Abbott, Chicago, IL, USA) by femoral access allowed exclusion of the SMPAVF and preserved arterial flow in the distal collaterals. During follow up, the patient developed portal vein thrombosis and required therapeutic anticoagulation for six months.DiscussionIn most cases, endovascular approaches are preferred in the management of SMPAVF. Endovascular approaches are based on minimally invasive techniques including embolisation (coiling or plug) and covered stenting. Vascular plug embolisation of SMPAVF is feasible and seems to be an effective technique, with the advantage of saving collaterals. Therapeutic anticoagulation should be considered post-operatively in cases with venous dilatation and reduced flow linked to exclusion of the AVF.

| S-EPMC10522866 | biostudies-literature

Multimodal treatments of brain arteriovenous malformations: a comparison of microsurgical timings after endovascular embolization.

Project description:BackgroundTo compare the clinical outcomes of hybrid microsurgery and embolization with multi-staged procedure for patients harboring brain arteriovenous malformations (bAVMs).MethodsWe retrospectively reviewed bAVM patients from a multicenter, prospectively collected database (NCT03774017) between June 2016 and June 2020. Patients were divided into single-staged hybrid operation (HO) group and multi-staged operation (MO) group according to the received treatment, in which microsurgeries were performed with embolization in a single setting or with multi-stage procedure, respectively. Cases were 1:1 matched between the two groups. Outcomes were compared between groups, which included neurological deficits (NDs), perioperative rupture, and proportion of complete resection. Variables associated with NDs were analyzed.ResultsIn total, 198 out of 544 cases were identified, including 120 in the HO group and 78 in the MO group. Sixty-six cases were matched in each group resulting in a total of 132 patients in this case-controlled study. Mean age was 29.2 years old, with 82 (62.1%) being male. No significant difference was observed in baseline demographics and clinical characteristics between the two groups. There were 7 ruptures occurred in the interval between embolization and microsurgery for MO group while none in the HO group (P=0.023). This yielded a rupture risk of 4.1% per year for the MO group. Duration of surgical resection was significantly reduced in HO group (P=0.001). Compared to MO, HO was more favorable to avoid short-term NDs (3.0% vs. 15.2%, P=0.021), but long-term outcomes were similar. The HO modality (OR, 0.110; 95% CI: 0.017-0.737; P=0.023) was confirmed as the protective factor for short-term NDs.ConclusionsHO is an effective setup to treat complex bAVMs with avoiding interval hemorrhage risk and reducing surgical risk. We also observed overall similar obliteration rate and resulting clinical outcomes between HO and MO.

| S-EPMC9358510 | biostudies-literature

Sylvian fissure arteriovenous malformations: case series and systematic review of the literature.

Project description:BackgroundSylvian fissure arteriovenous malformations are rare but important vascular lesions, whose importance lies in both haemorrhage and seizure risk. Although surgery has been recommended as a treatment, the overall estimation of success has not been reported to render outcomes easier to understand in comparison to other treatment modalities.ObjectivesThis systematic review of the literature and two cases aims to illustrate the results of surgery as a contemporary treatment option and present a novel anatomical classification system for Sylvian fissure arteriovenous malformations.Materials and methodsA systematic review was performed by searching MEDLINE (PubMed), EMBASE and Cochrane electronic bibliographic databases from conception to 2018. The following keywords were used: 'Sylvian fissure' AND 'AVM' OR 'arteriovenous malformation' OR 'intracranial arteriovenous malformation' OR 'cerebral arteriovenous malformation' OR 'brain arteriovenous malformation'. The search strategy was not limited by study design but only included keywords in the English language. In addition, two local institution Sylvian fissure arteriovenous malformations are presented and incorporated.ResultsA total of nine full-text articles were included in the analysis. The results of reported cases and the literature review emphasise the role of surgery in the treatment of Sylvian fissure arteriovenous malformations, with an acceptable result in carefully selected patients. We propose a classification system which may inform the choice of surgical approach for these lesions.ConclusionsSurgery remains the cornerstone of Sylvian fissure arteriovenous malformation treatment, which may apply to high-grade lesions in this special anatomical location.

| S-EPMC8649189 | biostudies-literature

Stereotactic Radiosurgery With vs. Without Prior Embolization for Brain Arteriovenous Malformations: A Propensity Score Matching Analysis.

Project description:Objective: Whether partial embolization could facilitate the post-stereotactic radiosurgery (SRS) obliteration for brain arteriovenous malformations (bAVMs) remains controversial. We performed this study to compare the outcomes of SRS with and without prior embolization for bAVMs. Methods: We retrospectively reviewed the Beijing Tiantan AVMs prospective registration research database from September 2011 to October 2014. Patients were categorized into two groups, combined upfront embolization and SRS (Em+SRS group) and SRS alone (SRS group), and we performed a propensity score matching analysis based on pre-embolization baseline characteristics; the matched groups each comprised 76 patients. Results: The obliteration rate was similar between SRS and Em+SRS (44.7 vs. 31.6%; OR, 1.754; 95% CI, 0.905-3.401; p = 0.096). However, the SRS group was superior to the Em+SRS group in terms of cumulative obliteration rate at a follow-up of 5 years (HR,1.778; 95% CI, 1.017-3.110; p = 0.033). The secondary outcomes, including functional state, post-SRS hemorrhage, all-cause mortality, and edema or cyst formation were similar between the matched cohorts. In the ruptured subgroup, the SRS group could achieve higher obliteration rate than Em+SRS group (56.5 vs. 31.9%; OR, 2.773; 95% CI, 1.190-6.464; p = 0.018). The cumulative obliteration rate at 5 years was also higher in the SRS group (64.5 vs. 41.3%; HR, 2.012; 95% CI, 1.037-3.903; p = 0.038), and the secondary outcomes were also similar between the matched cohorts. Conclusion: Although there was no significant difference in the overall obliteration rate between the two strategies, this study suggested that pre-SRS embolization may have a negative effect on post-SRS obliteration. Furthermore, the obliteration rates of the SRS only strategy was significantly higher than that of the Em+SRS strategy in the ruptured cohort, while no such phenomenon was found in the unruptured cohort.

| S-EPMC8545857 | biostudies-literature

Right Ventricular Myxoma Presenting in a Patient With Known Arteriovenous Malformations in the Brain: A Case Report.

Project description:AbstractCardiac myxomas extending from the right ventricle are uncommon and this rare condition is potentially associated with several risks and poor outcomes. We report the case of a patient with a right ventricular myxoma who had a recent haemorrhagic stroke due to an arteriovenous malformation. The preoperative and intraoperative managements were challenging and required several difficult choices by the medical team and consequently, a multidisciplinary approach and a benefit-risk evaluation were necessary to determinate timely surgical resection in an urgent situation, simultaneously avoiding delayed or improper treatments, achieving a successful outcome in a very high-risk situation.

| S-EPMC11902355 | biostudies-literature

OmicsDI is part of the ELIXIR infrastructure

OmicsDI is an Elixir interoperability service. Learn more ›

Tweets

OmicsDI Databases

PRIDE
PeptideAtlas
MassIVE
JPOST Repository
Physiome Model Repository

EGA
EVA
ENA
LINCS
PAXDB
Cell Collective

MetaboLights
Metabolomics Workbench
MetabolomeExpress
GNPS
BioModels
FAIRDOMHub

ArrayExpress
dbGaP
ExpressionAtlas
GEO
NODE

Information

Databases
Help
API
Contact us
Code on GitHub
Terms of use
Submit Data