Arteriovenous Malformations ; therapy ; Humans

Endovascular embolization has increasingly been applied for brain arteriovenous malformation (BAVM). With our better understanding of BAVM and the continuous improvement of micro-catheter technology and embolic materials, the therapeutic effectiveness has constantly increased. This paper reviews recent advances in research on BAVM and the application of endovascular embolization.
Embolization, Therapeutic ; Humans ; Intracranial Arteriovenous Malformations ; therapy

The clinical values of coils embolization in the treatment of pulmonary arteriovenous malformations (PAVM) and related complications were investigated. Eleven patients with PAVMs verified by pulmonary arterial angiography were treated by transcatheter coils embolization. Chest X-ray (11 cases), computer tomography (7 cases) and/or magnetic resonance imaging (2 cases) were performed before embolization. Blood-gas analysis was done in 5 cases before and after embolization. The follow-up materials of 8 patients were collected to evaluate the effect of embolization with coils. The clinical manifestations included cerebral embolus, hemoptysis and decreased oxygenation in 9 patients and the remaining 2 had no symptoms. 9/11 cases were found by chest X-ray and 8 were diagnosed definitely. 7/7, 2/2 cases were diagnosed by CT or MR and diagnosis was made in all cases. Embolization was performed in 29 vessels. Partial pressure of oxygen in arterial blood of 5 cases changed significantly before and after embolization. Slight complications occurred in 6 patients, such as low fever, chest pain, pleurisy. The follow-up results showed that 7 cases were cured effectively. No primary and secondary device migration, and no medical paradoxical embolization occurred. It was concluded that coils embolization is a well-established method for treating PAVMs. It is a minimally invasive lung preserving treatment with high efficiency and less complication.
Angiography ; Arteriovenous Malformations/diagnosis ; Arteriovenous Malformations/*therapy ; Embolization, Therapeutic/*instrumentation ; Follow-Up Studies ; Magnetic Resonance Angiography ; Pulmonary Artery/*abnormalities ; Pulmonary Veins/*abnormalities ; Treatment Outcome

Pulsatile tinnitus is a rarely occurring symptom of vascular origin. Most frequently, the symptoms are due to an arteriovenous malformation, to a tumor of the jugular glomus or to a local arterial stenosis. A 39-yr-old Korean male suffering from pulsatile tinnitus of the left ear was diagnosed to have dural arteriovenous malformation of the jugular bulb. Magnetic resonance imaging and angiography revealed a high-velocity vascular lesion encroaching the internal jugular vein and sigmoid sinuses. Digital subtraction angiography demonstrated a dural arteriovenous malformation involving the jugular bulb. The arterial supply was from the neuromeningeal branch of the left ascending pharyngeal artery and inferior tympanic artery. Stenosis of the left jugular vein caused retrograde venous drainage through the contralateral transverse sinus. Superselective embolization of these feeding arteries was successfully performed using 25% mixture of N-butylcyanoacrylate and lipiodol. In postembolization period, his complaints of pulsatile tinnitus and buzzing noise behind his left ear disappeared.
Adult ; *Embolization, Therapeutic ; Human ; Intracranial Arteriovenous Malformations/*therapy ; Jugular Veins/*abnormalities ; Male ; Tinnitus/etiology

Hereditary hemorrhagic telangiectasia (HHT, also called Osler-Weber-Rendu Disease) is a rare systemic fibrovascular dysplasia characterized by recurrent epistaxis, cutaneous telangiectasia, and visceral arteriovenous malformations (AVMs). HHT is an autosomal dominant disease with a prevalence of 1 in 5,000~8,000. Recurrent epistaxis is often the first and most common manifestation, and about 30% of patients reveal pulmonary AVM. Presently, we report a familial case of HHT. A 61-year-old male with asymptomatic multiple pulmonary AVMs was successfully treated with embolization. His older brother who presented with recurrent epistaxis and multiple telangiectasias was treated with laser ablation. Their pedigree revealed a family history of recurrent epistaxis.
Arteriovenous Malformations ; Epistaxis ; Humans ; Laser Therapy ; Male ; Middle Aged ; Pedigree ; Prevalence ; Siblings ; Telangiectasia, Hereditary Hemorrhagic ; Telangiectasis

The laser is a new surgical modality that utilizes high intensity beams of radiant energy to vaporize or coagulate tissue. Radiant energy is generated by stimulated emission of photons, resulting in a unidirectional monochromatic beam that is temporary coherent small diameter beams of great power density are achievable by this means. The author reviewed 12 months experience with a CO2 laser involving neurosurgical operations. 29 neurosurgical lesion, i, e. brain tumor 17 intracerebral hemorrhage 10, cerebral paragonimiasis 1, and arteriovenous malformation 1, were removed with the use of Shaplan, CO2 laser since 1981. We have conclude that there had been a significant reduction in blood loss and neurological morbidity through it was readily conceded that the number of operations were relatively small. The particular advantages of the combination of CO2 laser and microscope were felt to be precision, reduction of mechanical trauma, good hemostasis and low cost. Especially the blood loss and replacement during operation have been reduced.
Arteriovenous Malformations ; Brain Neoplasms ; Cerebral Hemorrhage ; Hemostasis ; Laser Therapy* ; Lasers, Gas ; Paragonimiasis ; Photons

The laser is a new surgical modality that utilizes high intensity beams of radiant energy to vaporize or coagulate tissue. Radiant energy is generated by stimulated emission of photons, resulting in a unidirectional monochromatic beam that is temporary coherent small diameter beams of great power density are achievable by this means. The author reviewed 12 months experience with a CO2 laser involving neurosurgical operations. 29 neurosurgical lesion, i, e. brain tumor 17 intracerebral hemorrhage 10, cerebral paragonimiasis 1, and arteriovenous malformation 1, were removed with the use of Shaplan, CO2 laser since 1981. We have conclude that there had been a significant reduction in blood loss and neurological morbidity through it was readily conceded that the number of operations were relatively small. The particular advantages of the combination of CO2 laser and microscope were felt to be precision, reduction of mechanical trauma, good hemostasis and low cost. Especially the blood loss and replacement during operation have been reduced.
Arteriovenous Malformations ; Brain Neoplasms ; Cerebral Hemorrhage ; Hemostasis ; Laser Therapy* ; Lasers, Gas ; Paragonimiasis ; Photons

BACKGROUNDNon-adhesive liquid embolic agents are increasingly gaining importance in the embolization of cerebral arteriovenous malformations (AVMs). We investigated the use of poly (N-isopropylacrylamide) (PNIPAM) as a non-adhesive embolic agent in swine rete mirabile.

METHODSThe PNIPAM hydrogel was mixed with iohexol and embolization was performed in swine rete mirabile in 30 animals. The microcatheter was examined after embolization. Follow-up angiography was performed for embolic efficacy after embolization. Embolized retia were examined histopathologically, and the alterations of inside rete and surrounding tissue were observed.

RESULTSThe copolymer hydrogel was used for rete embolization in 30 swine, 28 swine survived the procedure, 2 swine died, 1 swine died of cerebrum infarction and the other died of embolic agent reflux into the occipital artery. The inside wall of the microcatheter was smooth, without copolymer adhering to it. Follow-up angiography was performed in 22 swine, there was no rete recanalization in 20 swine and partial rete recanalization in 2 swine because of the trunk embolization of ascending pharyngeal arteries. Histopathologically, the copolymer was found diffused into vessels of 100 - 150 microm in diameter. In acute group, neutrophils scattered surrounding the copolymer and endothelial integrity was observed, without endothelial denuding and necrosis. In subacute and chronic groups, the copolymer was found inside retia, a few mononuclear cells and eosinocytes scattered inside and surrounding it. The muscular layer was loosened with most muscular nuclei degraded.

CONCLUSIONExperimental rete embolization with PNIPAM, made radiopaque with iohexol, is technically feasible in swine. Because of its properties, PNIPAM has great potential as a therapeutic non-adhesive embolic agent.

Acrylic Resins ; Animals ; Embolization, Therapeutic ; methods ; Intracranial Arteriovenous Malformations ; therapy ; Swine

OBJECTIVETo determine the effect, safety, and feasibility of embolization of high flow arteriovenous malformations (AVMs) with HepaSphere microspheres.

METHODSHepaSphere particles swell by absorbing fluids and become soft and deformable with a precisely calibrated diameter. 13 patients with AVMs were treated by transarterial embolization with HepaSphere particles. 3 cases underwent a following AVMs resection surgery. The follow-up period was 3 months to 3 years. Symptoms improvement and image examination were studied.

RESULTS28 transarterial embolizations were performed in 13 cases. The resection operation was performed in 3 cases after transarterial embolizations. The symptoms in diffused AVMs improved after several transarterial embolizations. Histologically, HepaSphere particles penetrated into the intralesional vessels and conformed to the vessel lumen, resulting in vessel occlusion. Minimal perivascular reaction was observed.

CONCLUSIONSEmbolization of high flow AVMs with HepaSphere microspheres is safe and effective. Combined treatment is necessary for diffuse AVMs.

Adolescent ; Adult ; Arteriovenous Malformations ; therapy ; Embolization, Therapeutic ; methods ; Female ; Humans ; Male ; Microspheres ; Middle Aged ; Young Adult

Arteriovenous Malformations ; therapy ; Child ; Female ; Humans ; Pulmonary Artery ; abnormalities ; Pulmonary Veins ; abnormalities ; Septal Occluder Device