Journal of Cerebrovascular and Endovascular Neurosurgery最新文献

{"title":"Surgical considerations and techniques using intraoperative indocyanine green angiography for ethmoidal dural arteriovenous fistula.","authors":"Hyeon Gyu Yang, Su-Hee Cho, Hong Beom Kim, Ku Hyun Yang","doi":"10.7461/jcen.2023.E2023.04.007","DOIUrl":"10.7461/jcen.2023.E2023.04.007","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the efficacy of microsurgery with intraoperative indocyanine green (ICG) angiography as a treatment approach for ethmoidal dural arteriovenous fistula (DAVF).</p><p><strong>Methods: </strong>Between January 2010 and July 2021, our institution encountered a total of eight cases of ethmoidal DAVF. In each of these cases, microsurgical treatment was undertaken utilizing a bilateral sub-frontal interhemispheric approach, with the aid of intraoperative ICG angiography.</p><p><strong>Results: </strong>ICG angiography identified bilateral venous drainage with single dominance in four cases (50%) of ethmoidal DAVF, a finding that eluded detection during preoperative transfemoral cerebral angiography (TFCA). The application of microsurgical treatment, in conjunction with intraoperative ICG angiography, resulted in consistently positive clinical outcomes for all patients, as evaluated using the Glasgow Outcome Scale (GOS) at the 6-month postoperative follow-up assessment; six patients showed GOS score of 5, while the remaining two patients attained a GOS score of 4.</p><p><strong>Conclusions: </strong>The use of intraoperative ICG angiography enabled accurate identification of both dominant and non-dominant venous drainage patterns, ensuring complete disconnection of the fistula and reducing the risk of recurrence.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"30-36"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10285987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curative transvenous embolization for congenital multi-hole pial arteriovenous fistula.","authors":"Lane Fry, Aaron Brake, Catherine Lei, Frank A De Stefano, Adip G Bhargav, Jeremy Peterson, Koji Ebersole","doi":"10.7461/jcen.2023.E2022.07.010","DOIUrl":"10.7461/jcen.2023.E2022.07.010","url":null,"abstract":"<p><strong>Objective: </strong>Congenital intracranial pial arteriovenous fistula (PAVF) is a rare cerebral vascular pathology characterized by a direct shunt between one or more pial feeding arteries and a cortical draining vein. Transarterial endovascular embolization (TAE) is widely considered first line therapy. Curative TAE may not be achievable in the multihole variant due to the potential to harbor innumerable small feeding arteries. Transvenous embolization (TVE) may be considered to target the final common outlet of the lesion. Here, we present a series of four patients with complex multi-hole congenital PAVF treated with staged TAE followed by TVE.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients who underwent treatment for congenital, multi-hole PAVFs treated by a combined TAE/TVE approach at our institution since 2013.</p><p><strong>Results: </strong>We identified four patients with multi-hole PAVF treated by a combined TAE/TVE. Median age was 5.2 (0-14.7) years. Median follow-up of 8 (1-15) months by catheter angiography and 38 (23-53) months by MRI/MRA was obtained. TVE achieved complete occlusion in three patients that proved durable on radiographic follow-up and demonstrated excellent clinical outcomes with a modified Rankin Score (mRS) of 0 or 1. Complete occlusion of the draining vein was not achieved by TVE in one case. This patient is graded as pediatric mRS=5 three years post-procedure.</p><p><strong>Conclusions: </strong>With thorough technical considerations, our series indicates that TVE of multi-hole PAVF that are refractory to TAE is feasible and effective in arresting the consequences of chronic, high-flow AV shunting produced by this pathology.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"85-96"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10042892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of a posterior cerebral artery aneurysm in the context of complex cardio-cerebrovascular variations using the Tubridge flow diverter.","authors":"Adam A Dmytriw, Sahibjot Grewal, Nicole M Cancelliere, Aman B Patel, Vitor Mendes Pereira, Xiaolu Ren","doi":"10.7461/jcen.2023.E2023.04.009","DOIUrl":"10.7461/jcen.2023.E2023.04.009","url":null,"abstract":"<p><p>We present a case of intracranial aneurysm located in the P1 segment of left posterior cerebral artery in the context of tetralogy of Fallot. Complex variations included right aortic arch with abnormal branching. Also, the bilateral vertebral arteries were absent, with a type I persistent proatlantal intersegmental artery of the left side. The aneurysm was treated with endovascular intervention with a Tubridge flow diverter and was noted to be completely cured on 6-month follow-up. We discuss the many considerations in this patient including developmental and modern-era treatment.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"65-70"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995469/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigation guided small craniectomy and direct cannulation of pure isolated sigmoid sinus for treatment of dural arteriovenous fistula.","authors":"Jun Ho Shim, Gi Yong Yun, Jae-Min Ann, Jong-Hyun Park, Hyuk-Jin Oh, Jai-Joon Shim, Seok Mann Yoon","doi":"10.7461/jcen.2023.E2023.05.009","DOIUrl":"10.7461/jcen.2023.E2023.05.009","url":null,"abstract":"<p><p>Dural arteriovenous fistula (DAVF) is a rare condition affecting approximately 1.5% of 1,000,000 individuals annually. It frequently occurs in the transsigmoid and cavernous sinuses. An isolated sigmoid sinus is extremely rare and is treated by performing transfemoral transvenous embolization along the opposite transverse sinus. A 69-year-old woman presented with asymptomatic Borden type III/Cognard type III DAVF involving an isolated sigmoid sinus. She underwent a staged operation in which a navigation system was used to expose the sigmoid sinus in the operating room before transferring the patient to the angio suite for transvenous embolization. Various modalities have been used to treat DAVF, including surgical disconnection, transarterial embolization, transvenous embolization, and stereotactic radiosurgery. However, treating DAVF cases where the affected sinus is isolated can be challenging because an easily accessible surgical route may not be available. In this case, direct sinus cannulation and transvenous embolization were the most effective treatments.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"71-78"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10288836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flow diverter stenting for intracranial aneurysms in the pediatric population: Two case reports and literature review.","authors":"Akram M Eraky, Christina Feller, Hatem Tolba, Mokshal Porwal, Raphael H Sacho, Hirad Hedayat","doi":"10.7461/jcen.2023.E2023.04.001","DOIUrl":"10.7461/jcen.2023.E2023.04.001","url":null,"abstract":"<p><p>The Pipeline Embolization Device (PED) is a flow-diverting intraluminal device that is approved for use in adults 18 years or older with internal carotid artery aneurysms. However, it can also be used off-label in pediatric patients with aneurysms that cannot be resolved with traditional endovascular treatments. Herein, we present two cases of flow diversion in the pediatric population with complete obliteration of the aneurysm and excellent outcomes. Flow diversion has been shown to be a safe endovascular option in treating complex aneurysms in children. Larger-sized, multicenter trials are encouraged to compare outcomes between flow diversion and other aneurysm treatment options given the rarity of pediatric aneurysms.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"58-64"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10995473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10096861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra-aneurysmatic thrombectomy in a distal anterior cerebral artery aneurysm","authors":"J. Gómez-Amador, L. Tovar-Romero, Andrea Castillo-Matus, Ricardo Marian-Magaña, Jorge F Aragón-Arreola, M. Sangrador-Deitos, Alan Hernández-Hernández, Germán López-Valencia, G. Guinto-Nishimura, J. Rios-Zermeno","doi":"10.7461/jcen.2023.e2023.01.002","DOIUrl":"https://doi.org/10.7461/jcen.2023.e2023.01.002","url":null,"abstract":"Thrombectomy procedures following intra-aneurysmatic lesions are extremely rare, and few cases have been reported. This article describes a microsurgical intra-aneurysmatic thrombectomy (MIaT) for a distal anterior cerebral artery (DACA) aneurysm. We present the case of a 48-year-old female that was admitted to the emergency room, showing neurologic deterioration with focal deficits. A computed tomography angiography (CTA) scan revealed an aneurysm located in the distal segment of the left anterior cerebral artery. During the surgical procedure, after clipping, a wellformed clot was visualized through the aneurysm’s wall obstructing the left DACA flow. We proceeded to open the aneurysm’s dome to remove the thrombus and clip the aneurysm neck, re-establishing the flow of the left DACA.Intra-aneurysmatic thrombosis can occur as a complication during clipping, obstructing the distal flow of vital arteries and causing fatal results in the patient’s postoperative status. MIaT is a good technique for restoring the flow of the affected vessel and allows a secure aneurysm clipping after thrombus removal.","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":"26 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139131352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and risk factors after digital subtraction angiography: 1-year single-center study.","authors":"David C Lauzier, Alexander P Conway","doi":"10.7461/jcen.2023.E2023.04.008","DOIUrl":"10.7461/jcen.2023.E2023.04.008","url":null,"abstract":"","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"473-474"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9820162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroid plexus arteriovenous malformations: A systematic review.","authors":"Patricia Zhao, Georgios A Maragkos, Kevin S Livingstone, Kathryn N Kearns, Min S Park","doi":"10.7461/jcen.2023.E2023.02.002","DOIUrl":"10.7461/jcen.2023.E2023.02.002","url":null,"abstract":"<p><p>To systematically review the reported outcomes and complications of different treatment options for choroid plexus arteriovenous malformations (AVMs), specifically focusing on surgical resection and endovascular embolization. A systematic literature review was performed using a PubMed query for studies published between January 1975 and July 2021. All studies describing the clinical presentation, management, and outcome of confirmed choroid plexus AVM cases were included. A total of 20 studies were included in the final analysis. Of these, 18 were singlepatient case reports, one article contained two patients, and a single study was a cohort of 24 patients. Patient age ranged from one day to 61 years, with a mean of 31.8±20.4 years. Most choroid plexus AVMs were located in the lateral ventricles (14 patients, 70.0%), while there were four (20.0%) located in the third ventricle, and two in the fourth ventricle (10.0%). Almost all patients were treated with surgical resection (18 patients, 90%). In 14 patients (77.8%), complete resection of the AVM was achieved. A residual AVM was reported in one case (5.6%). Most patients were reported to have improved from their presentation status over time (14 patients, 70.0%). Presence or absence of long-term sequelae (e.g., neurologic deficits) were reported for 14 patients (70%). Eleven of these patients (78.6%) were reported to have no neurological sequelae. While data on choroid plexus AVMs remains limited, the available evidence suggests gross total resection of lesions in this location can be safely achieved with subsequent reduction in preoperative symptoms.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"373-379"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10096866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral approach for bilateral clipping of posterior communicating artery aneurysms in a hybrid operating room: A technical note.","authors":"Juan Luis Gómez-Amador, Pablo David Guerrero-Suárez, Jaime Jesús Martínez-Anda, Jorge Fernando Aragón-Arreola, Andrea Castillo-Matus, Ricardo Marian-Magaña, Marcos V Sangrador-Deitos, Alan Hernández-Hernández, Ernesto Javier Delgado-Jurado, Ricardo Santiago Villagrana-Sánchez, Abraham Gallegos-Pedraza, Jorge Luis Diaz-Espinoza","doi":"10.7461/jcen.2023.E2022.12.002","DOIUrl":"10.7461/jcen.2023.E2022.12.002","url":null,"abstract":"<p><p>Bilateral posterior communicating (pComm) artery aneurysms represent only 2% of mirror intracranial aneurysms. Usually, these are surgically approached through bilateral craniotomies for clipping. We present the case of a 50-year-old female presenting with headache and horizontal diplopia. Neurological examination revealed a left oculomotor palsy, with no other neurological deficits. Imaging studies revealed bilateral aneurysmatic lesions in both internal carotid arteries (ICA). A conventional left pterional approach was planned in order to treat the symptomatic aneurysm, and, if deemed feasible, a contralateral clipping through the same approach. The procedure was performed in a hybrid operating room (HOR), performing an intraoperative digital subtraction angiography (DSA) and roadmapping assistance during dissection and clipping. Transoperatively, a post-fixed optic chiasm was identified, with a wide interoptic space, which allowed us to perform the contralateral clipping through a unilateral approach. This technique for clipping bilateral pComm aneurysms can be performed when the proper anatomical features are met.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"468-472"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10500263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optochiasmatic cavernoma: Surgical treatment and outcomes.","authors":"Anton Konovalov, Oleg Saripov, Vadim Gadzhiagaev, Oleg Titov, Nikolay Lasunin, Abzal Zhumabekov, Dmitry Fomichev, Eliava Shalva Salvovich, Pavel Kalinin, Bipin Chaurasia","doi":"10.7461/jcen.2023.E2023.01.003","DOIUrl":"10.7461/jcen.2023.E2023.01.003","url":null,"abstract":"<p><strong>Objective: </strong>Optochiasmatic cavernoma is an extremely rare cerebral lesion. They account for approximately 1% of all cavernomas of the central nervous system. Reports on this pathology are limited. Abrupt visual deterioration is a common symptom of the disease. Treatment strategy and visual outcomes after different treatment approaches remain a subject for discussion.</p><p><strong>Methods: </strong>Patients operated in a period 2005-2021 were analyzed in this study. All patients preoperatively underwent computed tomography (CT) scan, CT-angiography, and magnetic resonance imaging (MRI). Visual function of the patients was assessed pre-op, post-op and at the follow-up. Duration of visual dysfunction was noted as well. Surgical details were also extracted from medical notes. All patients were followed up, and control MRI was performed one month after operation. We assessed surgical series of optochiasmatic cavernomas published for last 10 years. Further comparative analysis with our data was performed.</p><p><strong>Results: </strong>Five patients were included into this study. There were four men and one woman. Mean age comprised 33.8 years (range 20-48 years). Most patients were admitted to our hospital due to visual disturbances (80%). Visual function improved in four patients. Visual function was unchanged in one patient, lacking visual disturbancies pre-op. Complication developed in one patient.</p><p><strong>Conclusions: </strong>Optochiasmatic cavernomas are encountered extremely rare. Despite the use of contemporary diagnostic options, differential diagnosis remains challenging. Full diagnostic work-up is mandatory. After the diagnosis is made, surgical treatment should be considered first. Total microsurgical or endoscopic transsphenoidal removal of the optochiasmatic cavernoma is a relatively safe and effective treatment method facilitating improvement of visual function.</p>","PeriodicalId":15359,"journal":{"name":"Journal of Cerebrovascular and Endovascular Neurosurgery","volume":" ","pages":"411-419"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9840390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}