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

Valavanis A , Pangalu A , Tanaka M : Endovascular treatment of cerebral arteriovenous malformations with emphasis on the curative role of embolisation . Interv Neuroradiol 11 : Suppl 1 37 – 43 , 2005 63 Valavanis A , Yasargil MG : The endovascular treatment of brain arteriovenous malformations . Adv Tech Stand Neurosurg 24 : 131 – 214 , 1998 64 van Rooij WJ , Jacobs S , Sluzewski M , van der Pol B , Beute GN , Sprengers ME : Curative embolization of brain arteriovenous malformations with Onyx: patient selection, embolization

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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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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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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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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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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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Walter A. Hall, Edward H. Oldfield, and John L. Doppman

ischemia from arterial steal. 20, 24, 25, 27, 28, 36 Although Elsberg 17 first successfully treated a spinal AVM by surgery in 1914, treatment of spinal AVM's has included embolization since the work of Doppman, et al. , 14, 15 Newton and Adams, 26 and more recently by Djindjian, et al. , 10, 11 Riché, et al. , 30 and Horton, et al. 18 Various biologically inert embolic agents, including dura mater, metallic pellets, muscle fragments, blood clot, Gelfoam, silicone spheres, silicone fluid, isobutyl-2-cyanoacrylate (IBCA), and polyvinyl alcohol (PVA, formerly

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

S pinal metastases complicate the courses of 5 to 10% of cancer patients. 5 The primary treatment modalities for metastatic spinal tumors are radiotherapy and surgery; the goals are palliative and include neurological preservation or improvement, mechanical spinal stability, and local tumor control. 13, 18, 20 Certain tumors, such as RCC, are hypervascular. Preoperative embolization of hypervascular tumors significantly reduces intraoperative blood loss and improves the surgeon's ability to decompress the spinal cord and maximize tumor resection. 3–7, 11, 13

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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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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