Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 23
Filtrar
1.
Indian J Otolaryngol Head Neck Surg ; 76(1): 1208-1213, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-38440528

RESUMEN

We report a case of a 15-year-old Indian girl who presented with tinnitus, pain and ear discharge for one month and was preliminarily diagnosed with Chronic Suppurative Otitis Media (CSOM) with mastoiditis. She underwent a routine presurgical CT scan which revealed an aberrant vein, making it essential to exercise caution during surgery for CSOM. The aberrant vessel was identified as a Petrosquamous Sinus. A Petrosquamous Sinus is a persistent fetal vein that connects the transverse sinus with the retromandibular vein and may regress in an individual by birth. Its importance lies in the risk of haemorrhage it carries during otological surgeries. A Digital Subtraction Angiography proved to be a vital step in isolating the path of the vein for better visualisation of the course, thus giving a better idea about the anatomical relations of the vessel during the surgery. The tympanoplasty was performed with care to prevent damaging the vein. The patient had no complications in the postoperative period and made a quick recovery.

2.
Neurointervention ; 19(1): 57-60, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38359946

RESUMEN

Isolated posterior communicating artery (PCoA) aneurysms are rare, predominantly fusiform in morphology, and rarely present with subarachnoid hemorrhage. Endovascular management of this pathology is technically challenging due to extreme tortuosity, the artery course in the subarachnoid space, sharp angulations at PCoA junctions with the parent artery, and, at times, associations with either internal carotid artery or basilar artery occlusions. We present a case of a ruptured fusiform PCoA at the junction of middle and distal third with concomitant proximal basilar artery occlusion. The PCoA reforms the posterior circulation, making it a vital artery. Stent-assisted coiling was performed with extreme difficulty in achieving distal positioning of the stents in the basilar artery/posterior cerebral artery/distal PCoA due to artery tortuosity. There was technical difficulty in the stent deployment. After changing strategies to a larger diameter laser-cut stent, endovascular treatment could be performed. There were good angiographic and clinical outcomes with stable occlusion at 6-month-follow-up.

3.
BJR Case Rep ; 10(1): uaad006, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38352267

RESUMEN

The coronavirus pandemic is now a public health emergency and has spread to nearly 206 countries across the globe. This novel disease has shaken the psycho-social, economic, and medical infrastructure of India. This has become even more challenging, considering the country's huge population. With the increase in the number of coronavirus disease (COVID) cases, our country has seen an unforeseen, unprecedented rise in a potential life and organ-threatening disease-mucormycosis. Mucormycosis is a deadly, extremely morbid, possibly life-threatening, and most feared complication of the coronavirus, caused by environmental molds belonging to the order Mucorales. Here, we report 2 cases of massive epistaxis due to internal carotid artery (ICA) pseudoaneurysm secondary to mucormycosis, post-COVID-19 pneumonia, which was managed by the endovascular route. To the best of our knowledge, there is very sparse literature available describing endovascular treatment of intracranial ICA pseudoaneurysm in a patient with COVID-induced mucormycosis.

4.
J Anaesthesiol Clin Pharmacol ; 39(2): 309-312, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37564835

RESUMEN

We report anesthesia management of sclerotherapy for vascular malformations (VMs) of the upper airway and face of pediatric patients conducted under sedation using a high-flow nasal cannula (HFNC) oxygen delivery system. Sclerotherapy procedures were carried out in six patients (five males, one female; age group: 5-12 years). The patients were sedated with midazolam, fentanyl, ketamine, and graded doses of propofol along with continuous oxygen delivery using HFNC. There were no episodes of oxygen desaturation, tongue fall or obstruction of the airway, interruption of procedure for assisted ventilation, and postoperative nausea and vomiting (PONV). Only two patients showed transient apnea for 10 and 15 s but did not require ventilatory assistance. HFNC provides effective oxygenation in pediatric patients undergoing sclerotherapy of VMs of the upper airway and face under sedation.

5.
Neurol India ; 69(3): 748-750, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34169882

RESUMEN

The incidence of cerebral aneurysms is rare in children, and it has to be definitively ruled out in all cases of intracranial bleed even if there is associated history of trauma. We report a case of 11-month-old girl who presented with intracranial bleed after a history of minor trauma whose diagnosis of an intracranial aneurysm was initially missed which later led to a rebleed. It was managed emergently with endovascular coiling and the patient showed incredible recovery in the post-operative period.


Asunto(s)
Aneurisma Roto , Embolización Terapéutica , Procedimientos Endovasculares , Aneurisma Intracraneal , Hemorragia Subaracnoidea , Aneurisma Roto/terapia , Angiografía Cerebral , Niño , Femenino , Humanos , Lactante , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/cirugía , Hemorragia Subaracnoidea/terapia , Resultado del Tratamiento
6.
Br J Neurosurg ; 32(5): 567-569, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-28092979

RESUMEN

HIV and tuberculosis infections are known to be associated with vasculopathy including occlusive disease and aneurysm formation. We report a case of 43-year-old male with miliary and central nervous system (CNS) tuberculosis; recently, diagnosed as HIV seropositive, on antiretroviral and antitubercular treatment presenting with painful neck swelling. He was found to have common carotid artery (CCA) pseudoaneurysm that was managed by endovascular stent grafting. HIV vasculopathy-related CCA pseudoaneurysm is a potentially life-threatening rare entity. Treatment of an immunocompromised patient by endovascular approach minimizes hospital stay and avoids wound-related complications. To the best of our knowledge, there has been no case report describing endovascular treatment of CCA pseudoaneurysm in an HIV-positive patient with low CD4 count and coexistent disseminated tuberculosis.


Asunto(s)
Traumatismos de las Arterias Carótidas/etiología , Traumatismos de las Arterias Carótidas/cirugía , Procedimientos Endovasculares/métodos , Infecciones por VIH/complicaciones , Tuberculosis del Sistema Nervioso Central/complicaciones , Tuberculosis Miliar/complicaciones , Adulto , Terapia Antirretroviral Altamente Activa , Antituberculosos/uso terapéutico , Recuento de Linfocito CD4 , Arteria Carótida Común , Humanos , Huésped Inmunocomprometido , Masculino , Stents , Tuberculosis del Sistema Nervioso Central/tratamiento farmacológico , Tuberculosis Miliar/tratamiento farmacológico
7.
J Neurointerv Surg ; 9(9): e36, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28235952

RESUMEN

A rete mirabile is a vascular network of intercommunicating small arteries or arterioles that replace the definitive adult artery supplying the brain. It supplies the brain in lower mammals but is not seen in normal human embryological development. A 26-year-old man presented with worsening tinnitus that was interfering with his sleep. On CT and digital subtraction angiography he was found to have a temporal lobe pial arteriovenous fistula with bilateral carotid and vertebral rete mirabile. The patient was offered open surgical and endovascular treatment options for pial arteriovenous fistula but he refused both and opted for conservative medical management. At 6-month follow-up he continued to have pulsatile tinnitus but was otherwise neurologically normal. We present the first described association of rete mirabile with pial arteriovenous fistula and discuss its clinical presentation and imaging features, with a review of the literature for bilateral carotid and vertebral rete mirabile.


Asunto(s)
Fístula Arteriovenosa/diagnóstico por imagen , Piamadre/irrigación sanguínea , Piamadre/diagnóstico por imagen , Lóbulo Temporal/irrigación sanguínea , Lóbulo Temporal/diagnóstico por imagen , Acúfeno/diagnóstico por imagen , Adulto , Angiografía de Substracción Digital/métodos , Fístula Arteriovenosa/complicaciones , Fístula Arteriovenosa/terapia , Humanos , Masculino , Acúfeno/etiología , Acúfeno/terapia , Arteria Vertebral/diagnóstico por imagen
8.
BMJ Case Rep ; 20172017 Feb 16.
Artículo en Inglés | MEDLINE | ID: mdl-28209646

RESUMEN

A rete mirabile is a vascular network of intercommunicating small arteries or arterioles that replace the definitive adult artery supplying the brain. It supplies the brain in lower mammals but is not seen in normal human embryological development. A 26-year-old man presented with worsening tinnitus that was interfering with his sleep. On CT and digital subtraction angiography he was found to have a temporal lobe pial arteriovenous fistula with bilateral carotid and vertebral rete mirabile. The patient was offered open surgical and endovascular treatment options for pial arteriovenous fistula but he refused both and opted for conservative medical management. At 6-month follow-up he continued to have pulsatile tinnitus but was otherwise neurologically normal. We present the first described association of rete mirabile with pial arteriovenous fistula and discuss its clinical presentation and imaging features, with a review of the literature for bilateral carotid and vertebral rete mirabile.


Asunto(s)
Fístula Arteriovenosa/diagnóstico por imagen , Arteria Carótida Interna/anomalías , Arterias Cerebrales/anomalías , Venas Cerebrales/anomalías , Malformaciones Arteriovenosas Intracraneales/diagnóstico por imagen , Arteria Vertebral/anomalías , Adulto , Angiografía de Substracción Digital , Arteria Carótida Interna/diagnóstico por imagen , Arterias Cerebrales/diagnóstico por imagen , Venas Cerebrales/diagnóstico por imagen , Humanos , Masculino , Ultrasonografía Doppler , Arteria Vertebral/diagnóstico por imagen
9.
Indian J Radiol Imaging ; 26(4): 510-512, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-28104948

RESUMEN

Posttraumatic external carotid artery pseudoaneurysm with arteriovenous fistula is a rare condition. An 8-year-old child presented with painful pulsatile swelling in the preauricular region following a penetrating glass shrapnel injury. Detailed evaluation showed distal external carotid artery pseudoaneurysm with fistula, which was draining into the retromandibular vein. Endovascular treatment was performed. This case highlights the role of endovascular intervention for such rare complicated vascular pathologies.

10.
J Neurointerv Surg ; 8(1): e1, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25428448

RESUMEN

Rete mirabile is a fine meshwork of anastomosing vessels that replace the parent artery. A 30-year-old woman complained of slurring of speech, right eye proptosis, recurrent vomiting, and loss of bladder and bowel control, followed by drowsiness lasting 30-40 min, for the past 6 months. On cross sectional imaging and angiography, the patient was found to have a vein of Galen aneurysmal malformation, with bilateral carotid and vertebral rete mirabile. The patient was offered both endovascular and open surgical options but she refused any form of surgical treatment and opted for conservative management. At the 6 month follow-up, she continued to have occasional episodes of headache and vomiting but was otherwise normal. We describe the clinical, cross sectional, and angiographic features of this patient. A comparison with other patients with bilateral carotid and vertebral rete mirabile is also reported.


Asunto(s)
Arteria Carótida Interna/diagnóstico por imagen , Malformaciones de la Vena de Galeno/complicaciones , Malformaciones de la Vena de Galeno/diagnóstico , Arteria Vertebral/diagnóstico por imagen , Adulto , Angiografía de Substracción Digital , Femenino , Humanos , Malformaciones de la Vena de Galeno/diagnóstico por imagen
11.
J Neurointerv Surg ; 7(7): e26, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25006042

RESUMEN

A 43-year-old man presented with acute subarachnoid hemorrhage. He was investigated and found to have a rare posterior condylar canal dural arteriovenous fistula (DAVF). DAVFs of the posterior condylar canal are rare. Venous drainage of the DAVF was through a long, tortuous, and aneurysmal bridging vein. We describe the clinical presentation, cross sectional imaging, angiographic features, and endovascular management of this patient. The patient was treated by transarterial embolization of the fistula through the ascending pharyngeal artery. This is the first report of an acutely bled posterior condylar canal DAVF treated by transarterial Onyx embolization with balloon protection in the vertebral artery. The patient recovered without any neurological deficit and had an excellent outcome. On 6 month follow-up angiogram, there was stable occlusion of the dural fistula.


Asunto(s)
Malformaciones Vasculares del Sistema Nervioso Central/cirugía , Manejo de la Enfermedad , Procedimientos Endovasculares/métodos , Cóndilo Mandibular , Hemorragia Subaracnoidea/cirugía , Adulto , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico , Heparina/administración & dosificación , Humanos , Masculino , Hemorragia Subaracnoidea/diagnóstico
12.
BMJ Case Rep ; 20142014 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-25414211

RESUMEN

Rete mirabile is a fine meshwork of anastomosing vessels that replace the parent artery. A 30-year-old woman complained of slurring of speech, right eye proptosis, recurrent vomiting, and loss of bladder and bowel control, followed by drowsiness lasting 30-40 min, for the past 6 months. On cross sectional imaging and angiography, the patient was found to have a vein of Galen aneurysmal malformation, with bilateral carotid and vertebral rete mirabile. The patient was offered both endovascular and open surgical options but she refused any form of surgical treatment and opted for conservative management. At the 6 month follow-up, she continued to have occasional episodes of headache and vomiting but was otherwise normal. We describe the clinical, cross sectional, and angiographic features of this patient. A comparison with other patients with bilateral carotid and vertebral rete mirabile is also reported.


Asunto(s)
Arteria Carótida Interna/diagnóstico por imagen , Venas Cerebrales/diagnóstico por imagen , Malformaciones de la Vena de Galeno/complicaciones , Arteria Vertebral/diagnóstico por imagen , Adulto , Angiografía Cerebral , Femenino , Humanos , Malformaciones de la Vena de Galeno/diagnóstico por imagen
13.
J Vasc Interv Neurol ; 7(4): 1-4, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25422703

RESUMEN

INTRODUCTION: We present two cases of Hereditary Hemmorhagic Telengiectasia (HHT), one pediatric and the other adult, with a view to highlight the myriad cerebral and spinal vascular manifestations of this disease. The syndrome and its various findings will be reviewed including the utility of angiography in assessing the various vascular abnormalities of the cerebral and spinal vasculature. METHODS: A review of literature regarding various developmental abnormalities including brain and spinal cord arterio-venous malformations (AVMs), arterio-venous fistulae (AVFs), micro AVMs, micro-fistulae, aneurysms and cavernomas that occur in pediatric and adult population subsets of HHT. Both patients underwent thorough clinical and laboratory evaluation. The pediatric patient underwent a contrast enhanced computed tomography (CECT) of the chest; cerebral, Pulmonary & celiac angiography. The adult patient underwent cerebral and spinal angiography. CONCLUSION: The spectrum of vascular malformations in Hereditary Hemorrhagic Telengiectasia (HHT) is varied.The incidence and manifestations of brain and spinal cord AVMs, AVFs, micro AVMs, micro-fistulae, aneurysms and cavernomas are different in the pediatric and adults affected by the disease. Cerebral and spinal angiography are necessary in characterising the various developmental vascular abnormalities in order to guide further management.

14.
BMJ Case Rep ; 20142014 Jul 02.
Artículo en Inglés | MEDLINE | ID: mdl-24990846

RESUMEN

A 43-year-old man presented with acute subarachnoid hemorrhage. He was investigated and found to have a rare posterior condylar canal dural arteriovenous fistula (DAVF). DAVFs of the posterior condylar canal are rare. Venous drainage of the DAVF was through a long, tortuous, and aneurysmal bridging vein. We describe the clinical presentation, cross sectional imaging, angiographic features, and endovascular management of this patient. The patient was treated by transarterial embolization of the fistula through the ascending pharyngeal artery. This is the first report of an acutely bled posterior condylar canal DAVF treated by transarterial Onyx embolization with balloon protection in the vertebral artery. The patient recovered without any neurological deficit and had an excellent outcome. On 6 month follow-up angiogram, there was stable occlusion of the dural fistula.


Asunto(s)
Malformaciones Vasculares del Sistema Nervioso Central/terapia , Embolización Terapéutica , Procedimientos Endovasculares , Hemorragia Subaracnoidea/etiología , Adulto , Malformaciones Vasculares del Sistema Nervioso Central/complicaciones , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico por imagen , Angiografía Cerebral , Humanos , Masculino , Hemorragia Subaracnoidea/diagnóstico , Hemorragia Subaracnoidea/diagnóstico por imagen
15.
J Craniomaxillofac Surg ; 42(7): 1480-5, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24954056

RESUMEN

OBJECTIVE: Dental arcade arteriovenous fistula (DA-AVF) are rare. The purpose of this study was to understand the angioarchitecture of these lesions, changing strategies of endovascular treatment and to analyse the best therapeutic option which will allow normal skeletal development especially in children. MATERIALS AND METHODS: Retrospective study of all the patients of DA-AVF managed at our centre over the last 16 years. Detailed analysis of the clinical features, the imaging findings, endovascular treatment and angiographic outcomes was done. RESULTS: Total of six patients were treated. 5 were in the mandible and one in the maxilla. Transarterial glue embolization was done in 3 patients and direct puncture of the intraosseous venous pouch in 2. Transarterial Onyx was used in 2 patients through dual lumen balloon catheter. Overall cure was achieved in 5 out of 6 patients (83%). CONCLUSION: High index of suspicion is required to diagnose it on panoramic radiographs. CT/MR/CTA can lead to early diagnosis. Transarterial Onyx embolization using dual lumen balloon catheter is a promising technique & allows excellent penetration of Onyx into the intraosseous venous pouch.


Asunto(s)
Fístula Arteriovenosa/diagnóstico , Arco Dental/irrigación sanguínea , Procedimientos Endovasculares/métodos , Adolescente , Adulto , Angiografía/métodos , Fístula Arteriovenosa/terapia , Cateterismo/instrumentación , Dimetilsulfóxido/administración & dosificación , Dimetilsulfóxido/uso terapéutico , Embolización Terapéutica/métodos , Enbucrilato/administración & dosificación , Enbucrilato/uso terapéutico , Femenino , Estudios de Seguimiento , Humanos , Inyecciones Intralesiones , Masculino , Mandíbula/irrigación sanguínea , Arteria Maxilar/anomalías , Procedimientos Quirúrgicos Mínimamente Invasivos , Polivinilos/administración & dosificación , Polivinilos/uso terapéutico , Estudios Retrospectivos , Resultado del Tratamiento , Adulto Joven
16.
Cardiovasc Intervent Radiol ; 37(5): 1376-80, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24556831

RESUMEN

Diverticula of the vascular system are rare. A diverticulum involving the retromandibular vein has not been described to date. We describe the imaging findings and a novel therapeutic strategy for the management of this rare diverticulum. A 25-year-old male presented with complaints of swelling behind the angle of mandible that enlarged on straining. On imaging, a retromandibular vein diverticulum was seen. The diverticulum was punctured percutaneously with the patient performing Valsalva maneuver and injected with sclerosant microfoam. There was no sclerosant reflux into the normal neck veins. At 6-month follow-up, the patient had complete resolution of his symptoms. We also have done a review of literature for patients with venous diverticula in the head and neck region treated by endovascular techniques.


Asunto(s)
Mandíbula/irrigación sanguínea , Soluciones Esclerosantes/uso terapéutico , Maniobra de Valsalva , Malformaciones Vasculares/diagnóstico por imagen , Adulto , Angiografía de Substracción Digital/métodos , Divertículo , Estudios de Seguimiento , Humanos , Inyecciones Intralesiones/métodos , Masculino , Mandíbula/diagnóstico por imagen , Soluciones Esclerosantes/administración & dosificación , Tetradecil Sulfato de Sodio/administración & dosificación , Tetradecil Sulfato de Sodio/uso terapéutico , Tomografía Computarizada por Rayos X/métodos , Resultado del Tratamiento , Ultrasonografía Doppler/métodos
17.
Cardiovasc Intervent Radiol ; 37(4): 1087-92, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24305988

RESUMEN

Cerebral hyperperfusion syndrome (CHS) describes a syndrome of sudden onset focal neurological features, unilateral headache, and systemic hypertension. Recurrent CHS in the same patient has not been described to date. We describe a 55-year-old woman who first developed CHS post intracranial stenting with sudden-onset right focal seizures and associated acute focal edema on imaging. After one and half years, the patient developed symptomatic in-stent restenosis and underwent repeat angioplasty with stenting. Postprocedure, the patient had another episode of CHS in the form of acute bleed in the basal ganglia and died. A review of literature of patients for CHS postintracranial angioplasty and stenting also was performed. The present case describes a rare clinical scenario where the patient had recurrent CHS with different clinical and imaging features.


Asunto(s)
Angioplastia/efectos adversos , Infarto Cerebral/terapia , Circulación Cerebrovascular , Stents Liberadores de Fármacos/efectos adversos , Hipertensión Intracraneal/etiología , Daño por Reperfusión/etiología , Angiografía de Substracción Digital , Angiografía Cerebral , Infarto Cerebral/diagnóstico , Diagnóstico por Imagen , Resultado Fatal , Femenino , Humanos , Hipertensión Intracraneal/diagnóstico por imagen , Persona de Mediana Edad , Recurrencia , Daño por Reperfusión/diagnóstico por imagen , Síndrome
18.
J Neurosurg Pediatr ; 10(3): 230-40, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22816607

RESUMEN

OBJECT: The aim of this study was to analyze the location, clinical presentation, and morphological characteristics of pediatric aneurysms and the safety, feasibility, and durability of endovascular treatment. METHODS: The authors conducted a retrospective study of all cases involving patients 18 years old or younger who underwent endovascular treatment for pediatric aneurysms at their institution between July 1998 and July 2010. The clinical presentation, aneurysm location, endovascular management, and treatment outcome were studied. RESULTS: During the study period, 23 pediatric patients (mean age 13 years, range 2 months-18 years) were referred to the authors' department and underwent endovascular treatment for aneurysms. The aneurysms were saccular in 6 cases, dissecting in 4, infectious in 5, and giant partially thrombosed lesions in 8. Fourteen of the aneurysms were ruptured, and 9 were unruptured. Thirteen were in the anterior circulation and 10 in the posterior circulation. The most common location in the anterior circulation was the anterior communicating artery; in the posterior circulation, the most common location was the basilar artery. Saccular aneurysms were the most common type in the anterior circulation; and giant partially thrombosed and dissecting aneurysms were the most common types in the posterior circulation. Coil embolization was performed in 7 cases, parent vessel sacrifice in 10, flow reversal in 3, glue embolization in 2, and stent placement in 1. Immediate angiographic cure was seen in 21 (91%) of 23 patients. Complications occurred in 4 patients, 3 of whom eventually had a good outcome. No patient died. Overall, a favorable outcome was seen in 22 (96%) of 23 patients. Follow-up showed stable occlusion of aneurysms in 96% of the patients. CONCLUSIONS: Pediatric aneurysms are rare. Their clinical presentation varies from intracranial hemorrhage to mass effect. They may also be found incidentally. Among pediatric patients with aneurysms, giant aneurysms are relatively common. Endovascular management is associated with low rates of complications and is a safe, durable, and effective treatment for pediatric aneurysms.


Asunto(s)
Angiografía Cerebral , Circulación Cerebrovascular , Embolización Terapéutica , Procedimientos Endovasculares , Aneurisma Intracraneal/diagnóstico , Aneurisma Intracraneal/terapia , Adolescente , Aneurisma Roto/diagnóstico , Aneurisma Roto/terapia , Isquemia Encefálica/etiología , Hemorragia Cerebral/etiología , Niño , Preescolar , Embolización Terapéutica/métodos , Procedimientos Endovasculares/efectos adversos , Procedimientos Endovasculares/métodos , Femenino , Humanos , Lactante , Aneurisma Intracraneal/complicaciones , Aneurisma Intracraneal/cirugía , Masculino , Estudios Retrospectivos , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Vasoespasmo Intracraneal/etiología
19.
Neurol India ; 60(6): 597-603, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-23287321

RESUMEN

BACKGROUND: Large size, and location in posterior circulation, both individually portend high risk in the endovascular management of intracranial aneurysms. AIM: The purpose of this study was to investigate the outcome of endovascular management of giant posterior circulation aneurysms at our centre. MATERIALS AND METHODS: This is a retrospective analysis of 22 consecutive patients with giant posterior circulation aneurysms, who were managed by endovascular techniques between 1997 and 2009. The aneurysms included: Vertebral-6 (27%), basilar or vertebrobasilar - 7 (32%) and nine posterior cerebral artery (PCA) - 9 (41%). RESULTS: There were 14 males and eight females with a mean age of 37 years. Treatment modalities included: Parent vessel sacrifice (PVS), coil embolization, flow reversal, stent-assisted coiling, and telescopic stent placement. Angiographic cure or stasis was achieved in 21 (95%) patients and no recurrence was observed in 17 of the 18 patients who had follow-up. Complications occurred in 9 (41%) patients, death in 4 and morbidity in 5 (3 with good eventual outcome). Overall, good clinical outcome was noted in 16 (73%) patients. The majority of the poor outcomes were observed in the management of basilar/vertebrobasilar aneurysms and flow reversal. Parent vessel sacrifice showed the best outcomes with stable results. CONCLUSIONS: Our results suggest that PVS remains the procedure of choice wherever possible and is relatively safe, particularly for giant vertebral and PCA aneurysms. When PVS is not feasible, stent-assisted coiling is a reasonable and safe option and requires follow-up. Management of basilar or vertebrobasilar aneurysms is complicated and still evolving.


Asunto(s)
Procedimientos Endovasculares/métodos , Aneurisma Intracraneal/cirugía , Adolescente , Adulto , Prótesis Vascular , Angiografía Cerebral , Procedimientos Endovasculares/instrumentación , Femenino , Humanos , Aneurisma Intracraneal/diagnóstico por imagen , Aneurisma Intracraneal/fisiopatología , Masculino , Persona de Mediana Edad , Arteria Cerebral Posterior/patología , Arteria Cerebral Posterior/fisiopatología , Estudios Prospectivos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
20.
Indian J Radiol Imaging ; 20(1): 26-33, 2010 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20351988

RESUMEN

OBJECTIVES: The purpose of this study was to establish the role of the liquid embolic agent, ONYX, in the treatment of cranial dural arteriovenous fistulae (DAVFs) and to redefine the indications, techniques and outcomes of treatment with ONYX. MATERIALS AND METHODS: This is a retrospective study of 25 DAVF patients who underwent endovascular treatment with ONYX between February 2006 and July 2008. All patients of DAVF presenting in this period were treated with ONYX. RESULTS: Anatomic cure (i.e., complete angiographic closure of the fistula) was achieved in a single session and through a single arterial pedicle injection in 21 out of 25 patients (cure rate of 84%). Out of four patients with residual fistulae, one achieved cure that was evident on a control angiogram obtained at 3 months while three had no vascular access for further embolization and so were referred for radiosurgery. There was only one recurrence seen in angiograms obtained at the end of one year and this patient was re-embolized successfully with ONYX. Complications were seen in two patients. CONCLUSION: ONYX embolization of DAVFs has revolutionized the endovascular treatment of DAVFs, achieving high cure rates in a single session with minimal complications. Transarterial ONYX embolization should be the first option for all locations, except cavernous DAVFs.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...