[Study on inhibitory effect of arsenic trioxide on growth of rat C6 glioma cells].

OBJECTIVE: To explore the inhibitory effect of arsenic trioxide (A(s2)O3) on the growth of rat C6 glioma cells (C6 cells) as well as finding out the feasibility of using As2O3 as chemotherapy of gliomas. METHOD: C6 cells were treated by different dose of As2O3 (1, 2, 4, 6 and 8 micromol L(-1)). MTT assay and staining for PCNA were used for cell proliferation. Cell apoptosis was determined by TUNEL method and Bcl-2 expression was studied by Western blot. Parental rat C6 cells (5 x 10(5)/15 microL) were implanted into right caudate nucleus of male SD rats as control group. Rats bearing cerebral C6 gliomas as treated group were treated with 1 mmol x L(-1) As2O3. The general manifestation, survival time, MRI dynamic scanning and histopathological changes of all rats were observed. RESULT: All the treated cells showed decreased proliferation in vitro as detected by MTT method (P < 0.01) and staining for PCNA. In situ labeling apoptotic DNA fragment of the treated cells demonatrated that the cell apoptosis significantly increased following treatment with As2O3 (P < 0.01). Western blot showed that the expression of Bcl-2 protein was decreased. All rats in control group died of cerebral gliomas within 3 weeks after implantation of C6 cells (17.8 +/- 0.92) d. Eight out of 10 rats in treated group died within 24-36 days (32.1 +/- 1.35) d and other 2 ones kept alive beyond 120 days with one treated rat being totally disappear of the tumor foci and another having a little residue of tumor. CONCLUSION: The result demonstrates the potential efficacy of As2O3 in the treatment of gliomas. It also suggests that As2O3 may be a good candidate for chemotherapy of human gliomas.

Combined covered stent and onyx treatment for complex dural arteriovenous fistula involving the clivus and cavernous sinus.

BACKGROUND: Complex DAVFs involving both the clivus and cavernous sinus are rare, especially when associated with brainstem compression from a large varix. In this report, we describe the use of a covered stent in combination with a liquid embolic agent to cure a complex clival-cavernous DAVF. METHODS: A 46-year-old man presented with 6 months of dizziness, dysphagia, and progressive dysarthria. Magnetic resonance imaging showed tortuous and enlarged right cavernous and preclival flow voids. There were also bilateral prepontine varices compressing the ventral pons, which led to marked dorsal pontine edema. A cerebral angiogram revealed a clival DAVF supplied by multiple branches of the right ECA, as well as the MHT of the right ICA. RESULTS: An endovascular cure was achieved by deploying a covered stent in the right cavernous ICA, followed by transarterial embolization of the feeding arteries originating from the ECA with Onyx (ev3, Irvine, Calif). This combined approach resulted in complete occlusion of the fistula. His 1-month follow-up angiogram confirmed persistent occlusion of the fistula and preserved patency of the right ICA. The patient made a full recovery without any new symptoms, and he remained neurologically intact at 18-month follow-up. CONCLUSION: The combined technique of covered stent placement and Onyx transarterial embolization is valuable for the management of complex DAVFs supplied by branches of both the external and internal carotid arteries.

[Therapeutic effect of embolization of brain arteriovenous malformation with non-adhesive liquid embolic agent].

OBJECTIVE: To observe the clinical and pathological characteristics of brain arteriovenous malformations (BAVM) embolized with the non-adhesive aqueous embolic agent Onyx and evaluate its application in comprehensive treatment of BAVM. METHODS: Thirty-four patients underwent BAVM embolization using Onyx, and their clinical manifestations, architecture of the malformed vessels, emblization procedure, and complications associated with the procedures were recorded. The resected tissues after embolization with Onyx were observed with electron microscope, and the prognosis of the patients was estimated with modified Rankin Score (mRS). RESULTS: These patients included 21 male and 13 female patients with a mean age of 30.45-/+11.81 years and an estimated mean size of the nidus of 3.98-/+1.43 cm. The patients received a total of 52 endovascular treatment procedures with Onyx to embolize 86 feeding pedicals, which resulted in an average estimated size reduction of the nidus of (72.35-/+21.26)%. Complications associated with the procedure occurred in 7 patients, and 23 patients received surgical resection or radiosurgery after embolization. Follow-up of the patients for 6 months to 4 years showed that the mRS was below 3 in 32 cases and > or =3 in 2 cases. Vasodilatation, brain tissue edema surrounding the nidus, and inflammatory cell infiltration were observed in the resected tissues after embolization. In some major feeding pedicals, thrombus recanalization was observed after embolization with Onyx (diameter> or =3 mm). CONCLUSION: Endovascular treatment of BAVM with Onyx can achieve high occlusion rate, enhance the safety of operation and radiosurgery, and improve the clinical prognosis of the patients.