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Curing arteriovenous malformations using embolization

Matthew B. Potts, Daniel W. Zumofen, Eytan Raz, Peter K. Nelson, and Howard A. Riina

T reatment modalities for cerebral arteriovenous malformations (AVMs) include microsurgical resection, radiosurgical ablation, endovascular embolization, and combinations thereof. With so many strategies to choose from, the management of AVMs can be as complex as their anatomy. In general, resection is most often used for superficial, noneloquent, or ruptured lesions while radiosurgery is ideal for deeper, eloquent lesions with higher surgical risks. 15 Endovascular embolization, on the other hand, is typically reserved as an adjuvant treatment, either to

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Subselective preoperative embolization for meningiomas

A radiological and pathological assessment

Evelyn Teasdale, James Patterson, Douglas McLellan, and Peter Macpherson

T he use of preoperative embolization of certain meningiomas has been advocated because it can produce tumor necrosis and relatively avascular operative conditions. 1–3 These combine to facilitate surgical removal and so reduce the risks to the patient. The reports recommend the use of superselective catheterization and injection of Gelfoam or liquid embolic material, either with or without balloon occlusion of the proximal vessels. The complexity of this technique makes it time-consuming, and success cannot always be achieved even by the most skilled

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Rupture of aneurysms following balloon embolization

Jonathan E. Hodes, Allan J. Fox, David M. Pelz, and Sydney J. Peerless

I n North America, balloon embolization therapy of intracranial aneurysms is usually reserved for aneurysms of which the necks cannot be clipped directly for various reasons. These include aneurysms judged to be inaccessible, aneurysms with thick and sclerotic necks, or complex aneurysms giving rise to major branches or important perforating vessels. Endovascular detachable-balloon therapy of aneurysms may be accomplished by occlusion of the parent vessel 1, 2 or by insertion of a balloon into the aneurysm, sparing the parent artery and surrounding branches

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Cobb's syndrome and its treatment with embolization

Case report

Shin-ichi Miyatake, Haruhiko Kikuchi, Tomoaki Koide, Sen Yamagata, Izumi Nagata, Shun-suke Minami, and Reinin Asato

C obb's syndrome is a rare clinical entity. Only 28 cases are documented in the literature. 10 The case of a 15-year-old girl with cutaneomeningospinal angiomatosis at the thoracic level is presented, and the characteristic magnetic resonance (MR) findings are described. The disorder was successfully treated with liquid embolization using ethylene vinyl alcohol (EVAL). Case Report This 15-year-old girl had been operated on for a ventricular septal defect in her infancy and had suffered the sudden onset of monoparesis of her right lower extremity 8 years

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Microvascular embolization of cerebral arteriovenous malformations

A technical variation

Sean Mullan, Henry Kawanaga, and Nicholas J. Patronas

embolization techniques. Conventionally there are two techniques of embolization. Plastic spheres may be injected into the carotid artery, usually during open operation, or transfemorally into a rather large catheter which dilates the site of puncture. The carotid operation is basically undesirable if a simpler method of introduction exists. The large femoral catheter is a source of worry, especially in the older atherosclerotic patient. Recently we have used a system of embolization which appears to offer some advantages. These emboli may be fashioned in size and shape to

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Embolization of cerebral arteriovenous malformations with bucrylate

Experience in 46 cases

Gérard Debrun, Fernando Vinuela, Allan Fox, and Charles G. Drake

N eurosurgeons and neuroradiologists have tried different types of embolization to treat nonresectable cerebral arteriovenous malformations (AVM's). The variety of techniques used shows that there is no clear consensus about the best method of embolization. Luessenhop and his co-workers did pioneer work, and in 1960 published their first results of embolization of cerebral AVM's with plastic or steel emboli, 8 with a follow-up review 15 years later. 7 The factors governing successful embolization of cerebral AVM's with spheres or particles injected in the

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Results of preoperative embolization for metastatic spinal neoplasms

Vikram C. Prabhu, Mark H. Bilsky, Kedar Jambhekar, Katherine S. Panageas, Patrick J. Boland, Eric Lis, Linda Heier, and P. Kim Nelson

spinal tumors: influence of the embolization technique on perioperative hemorrhage. AJNR 20: 757–763, 1999 4. Bhojraj SY , Dandawate AV , Ramakantan R : Preoperative embolisation, transpedicular decompression, and posterior stabilisation for metastatic disease of the thoracic spine causing paraplegia. Paraplegia 30 : 292 – 299 , 1992 Bhojraj SY, Dandawate AV, Ramakantan R: Preoperative embolisation, transpedicular decompression, and posterior stabilisation for metastatic disease of the thoracic spine causing paraplegia

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Postmortem findings following the embolization of an arteriovenous malformation

Case report

Alan S. Fleischer, I. Kricheff, and Joseph Ransohoff

I n recent years a new technique for dealing with otherwise untreatable cerebral arteriovenous malformations (AVM) has been introduced by Luessenhop and his associates. 5, 6 This method consists of extracranial carotid embolization of the malformation, utilizing Silastic spheroids. This report describes the rare postmortem examination of a brain following this type of embolization of a large cerebral AVM. Case Report Clinical Data February 16, 1971, was the first University Hospital admission for this 52-year-old man following his eighth

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Controversies in the role of preoperative embolization in meningioma management

Amit Singla, Eric M. Deshaies, Vlad Melnyk, Gentian Toshkezi, Amar Swarnkar, Hoon Choi, and Lawrence S. Chin

presurgical embolization of feeding arteries in 137 intracranial meningeal tumors . Acta Neurochir (Wien) 155 : 707 – 714 , 2013 10.1007/s00701-013-1632-1 18 Lefkowitz M , Giannotta SL , Hieshima G , Higashida R , Halbach V , Dowd C , : Embolization of neurosurgical lesions involving the ophthalmic artery . Neurosurgery 43 : 1298 – 1303 , 1998 19 Macpherson P : The value of pre-operative embolisation of meningioma estimated subjectively and objectively . Neuroradiology 33 : 334 – 337 , 1991 10.1007/BF00587818 20 Manelfe C , Guiraud

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Embolization of cerebral vessels with inflatable and detachable balloons

Technical note

Lauri Laitinen and Antti Servo

the balloon then closes by itself. The neck is usually airtight and watertight, and is reliable for use with oilsoluble x-ray contrast media ( Fig. 2 ). * Fig. 1. Diagram showing embolization technique using inflatable and detachable balloon catheter. See text for details. Fig. 2. The balloon, originally 4 mm long and 0.6 mm thick (outer diameter), can be inflated (here with tea) to a size of 5 × 8 mm. When the catheter tube is withdrawn from the balloon, the neck closes tightly by itself. We have left balloons in the arteries of three goats