RESUMO
BACKGROUND: Transophthalmic artery embolization of intracranial meningiomas is thought to be associated with a high complication risk. PURPOSE: With advances in endovascular techniques, we systematically reviewed the current literature to improve our understanding of the safety and efficacy of transophthalmic artery embolization of intracranial meningiomas. DATA SOURCES: We performed a systematic search using PubMed from inception until August 3, 2022. STUDY SELECTION: Twelve studies with 28 patients with intracranial meningiomas embolized through the transophthalmic artery were included. DATA ANALYSIS: Baseline and technical characteristics and clinical and safety outcomes were collected. No statistical analysis was conducted. DATA SYNTHESIS: The average age of 27 patients was 49.5 (SD, 13) years. Eighteen (69%) meningiomas were located in the anterior cranial fossa, and 8 (31%), in the sphenoid ridge/wing. Polyvinyl alcohol particles were most commonly (n = 8, 31%) used to preoperatively embolize meningiomas, followed by n-BCA in 6 (23%), Onyx in 6 (23%), Gelfoam in 5 (19%), and coils in 1 patient (4%). Complete embolization of the target meningioma feeders was reported in 8 (47%) of 17 patients; partial embolization, in 6 (32%); and suboptimal embolization, in 3 (18%). The endovascular complication rate was 16% (4 of 25), which included visual impairment in 3 (12%) patients. LIMITATIONS: Selection and publication biases were limitations. CONCLUSIONS: Transophthalmic artery embolization of intracranial meningiomas is feasible but is associated with a non-negligible complication rate.
Assuntos
Embolização Terapêutica , Neoplasias Meníngeas , Meningioma , Humanos , Adulto , Meningioma/terapia , Neoplasias Meníngeas/terapia , Cuidados Pré-Operatórios/métodos , Embolização Terapêutica/métodos , Artérias , Resultado do Tratamento , Estudos RetrospectivosRESUMO
Mutations in pank2 gene encoding pantothenate kinase 2 determine a pantothenate kinase-associated neurodegeneration, a rare disorder characterized by iron deposition in the globus pallidus. To extend our previous work, we performed microinjections of a new pank2-specific morpholino to zebrafish embryos and thoroughly analyzed vasculature development. Vessels development was severely perturbed in the head, trunk, and tail, where blood accumulation was remarkable and associated with dilation of the posterior cardinal vein. This phenotype was specific as confirmed by p53 expression analysis and injection of the same morpholino in pank2-mutant embryos. We can conclude that pank2 gene is involved in vasculature development in zebrafish embryos. The comprehension of the underlining mechanisms could be of relevance for understanding of pantothenate kinase-associated neurodegeneration.
Assuntos
Vasos Sanguíneos/metabolismo , Coenzima A/farmacologia , Globo Pálido/metabolismo , Neurodegeneração Associada a Pantotenato-Quinase/prevenção & controle , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Animais , Vasos Sanguíneos/crescimento & desenvolvimento , Vasos Sanguíneos/patologia , Modelos Animais de Doenças , Embrião não Mamífero , Regulação da Expressão Gênica no Desenvolvimento , Globo Pálido/irrigação sanguínea , Globo Pálido/efeitos dos fármacos , Globo Pálido/patologia , Cabeça/irrigação sanguínea , Cabeça/crescimento & desenvolvimento , Humanos , Morfolinos/administração & dosagem , Morfolinos/genética , Morfolinos/metabolismo , Neurodegeneração Associada a Pantotenato-Quinase/genética , Neurodegeneração Associada a Pantotenato-Quinase/metabolismo , Neurodegeneração Associada a Pantotenato-Quinase/patologia , Fosfotransferases (Aceptor do Grupo Álcool)/antagonistas & inibidores , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Cauda/irrigação sanguínea , Cauda/crescimento & desenvolvimento , Cauda/metabolismo , Tronco/irrigação sanguínea , Tronco/crescimento & desenvolvimento , Proteína Supressora de Tumor p53/genética , Proteína Supressora de Tumor p53/metabolismo , Peixe-ZebraAssuntos
Peptídeos e Proteínas de Sinalização Intercelular/química , Infarto do Miocárdio/tratamento farmacológico , Peptídeos/farmacologia , Sequência de Aminoácidos , Animais , Pressão Sanguínea/efeitos dos fármacos , Creatina Quinase Forma MB/metabolismo , Frequência Cardíaca/efeitos dos fármacos , Peptídeos e Proteínas de Sinalização Intercelular/farmacologia , L-Lactato Desidrogenase/metabolismo , Masculino , Infarto do Miocárdio/metabolismo , Infarto do Miocárdio/patologia , Traumatismo por Reperfusão Miocárdica/patologia , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Peptídeos/química , Ratos , Ratos Wistar , Relação Estrutura-AtividadeRESUMO
We report a case of a 38-year-old woman with pheochromocytoma admitted to our department for an acute myocardial infarction. The diagnosis of pheochromocytoma was evoked in view of the major pressure variations that appeared secondarily. Pheochromocytoma is mainly medullosurrenal tumour with clinical polymorphism; it can lead to severe cardiovascular disorders. Nevertheless, cardiac involvement is rarely in the foreground. Our clinical case illustrates the importance to evoke the diagnosis of pheochromocytoma in front of atypical manifestations of acute coronary syndrome so as to reduce mortality.