Endovascular Treatment With Targeted Embolization of Cavernous Sinus Dural Arteriovenous Fistulas: A Single-Center Study
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To assess the feasibility, efficacy, and safety of targeted embolization for cavernous sinus dural arteriovenous fistulas (CSDAVF).Keywords:
Single Center
Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)
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One hundred ninety-eight surgically explored pituitary adenomas were evaluated preoperatively by high-resolution computed tomography (CT). At surgery, evidence of direct cavernous sinus invasion was demonstrated in 19. CT findings in these cases included cavernous sinus expansion (17 patients) and visible encasement of the internal carotid artery (14 patients). The invasive tumor often enhanced to a lesser degree than the cavernous sinuses and ipsilateral internal carotid artery. Intracavernous cranial nerve compression, obliteration, or displacement (14 patients), invasion of the lateral wall of the cavernous sinus (seven patients), and diffuse bone destruction (seven cases) were other findings. Magnetic resonance imaging in three patients provided excellent demonstration of intracavernous internal carotid artery encasement, but displacement and obliteration of intracavernous cranial nerves was not shown as well as it was with CT. Histologically, only three patients showed anaplastic features and only one of them had distant metastases. There was no correlation between histologic features, hormone assays, and invasiveness. This experience indicates any type of pituitary adenorha, regardless of its endocrinologic activity, can invade the cavernous sinus. Cavernous sinus involvement makes complete surgical removal difficult. Preoperative recognition of invasive behavior of these tumors has prognostic value and aids in designing appropriate management. CT is the most useful technique generally available for evaluation and follow-up.
Cranial nerves
Sinus (botany)
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BACKGROUND: The aim of this article was to show the outcomes of the endovascular and hybrid treatment for complex aortoiliac lesions, TransAtlantic Inter-Society Consensus II (TASC II) C and D, in a single center study.METHODS: From 2018 to 2021, 82 patients with aortoiliac occlusive disease (AIOD) underwent to endovascular and hybrid procedures in our center. Forty-eight patients (58.3%) were treated for TASC C and TASC D lesions; 25 patients belonged to TASC C category, and 23 belonged to the TASC D category.RESULTS: In 32 cases we performed a kissing-stent procedure, by implantation of preoaled covered stents (BeGraft Bentley®). In 18 cases we implanted a self-expanded bare stent (Epic® Boston Scientific) in the external iliac artery to improve outflow. In 15 patients we performed a hybrid procedure, by common femoral endarterectomy (CFE). Two patients concluded the procedure with a femoral-popliteal bypass above the knee (A/K) in ePTFE protheses and one patient with a femoro-popliteal bypass below the knee (B/K) with inverted great saphenous vein. Technical success was achieved in 97.9% of cases (47/48). One patient died at 8 months of follow-up. Two patients were lost at 6 months of follow-up. The mean follow-up time was 24.43 months (range 11-42 months). At 6 months the primary patency was 100% (the follow-up, up to 6 months, showed no evidence of re-stenosis at the EcoColorDoppler). The rate of reintervention was 4.2%. Two patients presented restenosis of the external iliac artery and were treated with PTA/stenting. At one and two years of follow-up, primary patency was 93.6% and 89,3%, respectively.CONCLUSIONS: The use of covered stents combined with CFE or hybrid technique is safe and provides good long-term results in treatment of TASC C and TASC D lesions and it can be considered as an alternative to open surgery in high-risk patients.
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Ömür S, Kasımzade F, Ada F, Dindaş F. Endovascular treatment of proximal venous outflow obstructions in patients with arteriovenous fistula: Our single-center experience. Turk J Vasc Surg 2022; 31(2): 072-077. http://dx.doi.org/10.9739/tjvs.2022.1169
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Outflow
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Sinus (botany)
Arteriovenous malformation
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Compartment (ship)
Sinus (botany)
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Dural arteriovenous fistula is anomalous arteriovenous shunt occurred in the dura mater.The main treatment occludes endovascular treatment and craniotomy,but the endovascular treatment is more effect and safe.In this paper,a method commonly used in endovascular therapy,indications,complications,and postoperative evaluation of the latest developments were reviewed.
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Selective and superselective renal embolization is a generally accepted technique for treating traumatic or iatrogenic renal arteriovenous fistulas or arteriocalyceal fistulas. Only a minority are pure arteriocalyceal fistulas. During embolization, an arteriovenous fistula may become a frankly bleeding arteriocalyceal fistula, causing massive haematuria and necessitating further embolization.
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Objective To explore the techniques and curative effects of endovascular embolization of ruptured intracraniala neurysms with detachable coils on them. Methods The endovascular embolization was performed in 141 patients with rupturedi ntracranial aneurysms, of whom, 86 received endovascular embolization only with the detachable coils, 24 with the balloons andd etachable coils, and 31 with the stents and detachable coils. Results Of 141 aneurysms, 93 were embolized by 100 %, 31 by 95 %, 10b y 90 %, 5 by less than 90% and 2 were unsuccessfully embolized. Three aneurysms ruptured again during the endovascular treatment.O f 141 patients, 107 were recovered well, 24 mildly disabled, 7 severly disabled and 3 patients died after the embolization. Of 127p atients followed up from 3 to 33 months, all the patients had no rebleeding and 7 had recurrent aneurysms. Conclusions Thee ndovascular embolization with detachable coils is a safe and effective method to treat the ruptured intracranial aneurysms. The deadr ate and disabled rate may be decreased by the early endovascular embolization and positive post-operative treatment in the patientsw ith ruptured intracranial aneurysms.
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Objective To find out the clinical significance of endovascular embolization in the treatment of cerebral arteriovenous malformation (AVM). Methods Clinically 37 patients were treated by endovascular embolization with NBCA and/or ONYX as embolic materials, followed by γ-knife therapy in 11 patients of them. Results After endovascular embolization, anatomical cure was achieved in 6 cases, more than 90% disappearance of the malformations in size in 11 cases, 70%~90% disappearance in 17 and less than 70% disappearance in 3. 2 cases of the group appeared periusion pressure-induced cerebral swelling, and other 2 cases suffered from hemorrhage after embolization. Conclusion Endovascular embolization is a safe and reliable method for treating AVM. In regard to some large AVMs or ones situated at important functional areas, endovascular embolization combined with surgery or γ- knife is an effective method for AVM with a high cure rate and a low morbiditv and mortalitv.
Arteriovenous malformation
Cure rate
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