scholarly journals A case of ruptured micro AVM diagnosed by superselective angiography

Nosotchu ◽  
2020 ◽  
Vol 42 (4) ◽  
pp. 248-252
Author(s):  
Kenji Miki ◽  
Naoki Noguchi ◽  
Megumu Mori ◽  
Tetsuhisa Yamada ◽  
Koichi Arimura ◽  
...  
Keyword(s):  
Superselective Angiography

scholarly journals Fusiform Lenticulostriate Artery Aneurysm with Subarachnoid Hemorrhage: The Role for Superselective Angiography in Treatment Planning

2010 ◽  
Vol 16 (3) ◽  
pp. 259-263 ◽  
Author(s):  
P.S. Kochar ◽  
W.F. Morrish ◽  
M.E. Hudon ◽  
J.H. Wong ◽  
M. Goyal
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Treatment Planning ◽  
Artery Aneurysm ◽  
Cerebral Angiogram ◽  
Perforating Artery ◽  
Ct Angiogram ◽  
Superselective Angiography ◽  
Lenticulostriate Artery ◽  
The Right ◽  
Exact Origin

Aneurysms of the lenticulostriatal perforating arteries are rare and either involve the middle cerebral artery-perforator junction or are located distally in basal ganglia. We describe a rare ruptured fusiform lenticulostriatal perforating artery aneurysm arising from a proximal M2 MCA branch, discerned on superselective microcatheter angiography, presenting solely with subarachnoid hemorrhage (SAH). A 50-year-old previously healthy man presented with diffuse SAH and negative CT angiogram. Cerebral angiogram demonstrated a 2 mm fusiform aneurysm presumably arising from the right lateral lenticulostriate perforator but the exact origin of the perforator was unclear. Superselective angiography was required to precisely delineate the aneurysm and its vessel of origin and directly influenced treatment planning (surgical trapping). Superselective microcatheter angiography provides both an option for endovascular therapy as well as more accurate delineation for surgical planning for these rare aneurysms.

scholarly journals Endovascular Hyaluronidase Application Through Superselective Angiography to Rescue Blindness Caused by Hyaluronic Acid Injection

2020 ◽  
Author(s):  
Lei Zhang ◽  
Zuyan Luo ◽  
Jian Li ◽  
Zhe Liu ◽  
Hong Xu ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Ophthalmic Artery ◽  
Emergency Situation ◽  
Artery Occlusion ◽  
Left Middle Cerebral Artery ◽  
Level Of Evidence ◽  
Vascular Intervention ◽  
Superselective Angiography ◽  
Sequential Treatments

Abstract Background Blindness is a rare but catastrophic complication of facial hyaluronic acid (HA) injection. Although various means to rescue visual impairment have been employed, no consensus regarding effective treatment has yet been reached. We organized a multidisciplinary team to address this emergency situation by means of endovascular hyaluronidase application. Objectives The aim of this study was to investigate the direct delivery of hyaluronidase to ophthalmic artery occlusion through endovascular cannulation to resolve HA-induced blindness. Methods Four patients with visual impairments caused by HA filler embolization were subjected to sequential treatments. Through superselective angiography, a microcatheter was introduced along a guidewire from the femoral artery to the ophthalmic artery to directly deliver hyaluronidase to the HA embolism. The safety and efficiency of this treatment were systematically analyzed. Results Selective cerebral angiography demonstrated that the endovascular application of hyaluronidase significantly alleviated occlusion in 3 patients. One patient showed slight visual improvement, whereas the other patients showed no improvement in their visual function during a follow-up period of more than 3 months. One patient suffered from cerebral infarction in the left middle cerebral artery during the intervention surgery. Moreover, 2 patients showed multiple lacunar cerebral infarctions after the operation, whereas none exhibited symptoms of hemiplegia during follow-up. Conclusions Although the endovascular application of hyaluronidase could partially recanalize the occluded branches of the ophthalmic artery, it had limited effects on restoring vision. Considering the risks of vascular intervention surgery, this approach should be considered with caution. Level of Evidence: 5

Angiographic investigation of orbital vascular variations in the rabbit and implications for endovascular intra-arterial chemotherapy models

2020 ◽  
pp. neurintsurg-2020-016460
Author(s):  
Michael T Froehler ◽  
Michael J Feldman ◽  
Bryan Poitras ◽  
Anthony B Daniels
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Zealand White Rabbit ◽  
Small Animal ◽  
External Carotid Artery ◽  
Arterial Supply ◽  
External Carotid ◽  
Superselective Angiography ◽  
Ophthalmic Arteries ◽  
Animal Experimental Model

BackgroundThe New Zealand White rabbit (NZWR) is the first small-animal experimental model of intra-arterial chemotherapy (IAC) for retinoblastoma treatment. The NZWR has dual ophthalmic arteries (OA): the external OA (EOA) arises from the external carotid artery and the internal OA (IOA) from the internal carotid artery. We describe the technique that we have refined for OA catheterization in rabbits, and describe the angioanatomical variations in the OA supply to the NZWR eye and implications for IAC delivery, which were identified as part of a larger project exploring IAC effects in a rabbit retinoblastoma model.MethodsWe developed techniques to perform angiography of the external and internal carotid arteries and superselective angiography of the EOA and IOA in NZWR using transfemoral access and a microwire/microcatheter system. EOA and IOA supply to the eye was determined angiographically and recorded before selective OA catheterization and angiography.Results114 rabbits underwent carotid angiographic evaluation and OA catheterization (161 total eyes evaluated, 112 right, 49 left). Most eyes had a single dominant arterial supply; either IOA or EOA. EOA was dominant in 73% (118/161), and IOA was dominant in 17% (27/161). Co-dominant supply was seen in 10% (16/161). Of the rabbits with bilateral OA catheterization, 25/47 (53%) had bilateral dominant EOA.ConclusionSuccessful catheterization of the OA in the NZWR can be readily accomplished with nuanced technique. The external OA is the dominant arterial supply in the majority of NZWR eyes. These findings allow for successful reproduction of OA catheterization studies of IAC for retinoblastoma in NZWR.

scholarly journals Role of Superselective Angiography in the Detection and Endovascular Treatment of Ruptured Occult Arteriovenous Malformations

2001 ◽  
Vol 7 (4) ◽  
pp. 303-311 ◽  
Author(s):  
M. Tanaka ◽  
A. Valavanis
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cerebral Angiography ◽  
Arteriovenous Malformations ◽  
Perimesencephalic Subarachnoid Hemorrhage ◽  
First Case ◽  
Superselective Embolization ◽  
Venous Filling ◽  
Superselective Angiography ◽  
Endovascular Approach

Three cases of occult micro-arteriovenous malformations not identified by cerebral angiography or other imaging modalities were detected by superselective angiography. The first case had a small intracerebral hemorrhage in the superior colliculus, the second had a perimesencephalic subarachnoid hemorrhage, and the third presented with intracerebral hemorrhage combined with massive intraventricular hematoma. While repeated selective cerebral angiography (four-vessel study) was negative, superselective angiography clearly demonstrated each lesion with small early venous filling in accordance with the location of hematoma. Successful superselective embolization with polyvinyl alcohol particles was performed in each micro-arteriovenous malformation by flow-guided microcatheter without postoperative complications. Our experience suggests that superselective angiography is necessary to visualize micro-arteriovenous malformations in patients with cerebral hemorrhage and negative four-vessel angiography. Furthermore, the superselective endovascular approach has the advantage of offering immediate obliteration of the micro-shunt, thereby reducing or eliminating the risk of further hemorrhage.

Superselective Angiography

JAMA ◽  
1978 ◽  
Vol 240 (12) ◽  
pp. 1271 ◽  
Author(s):  
Oscar Sugar
Keyword(s):  
Superselective Angiography

scholarly journals Selective and Superselective Angiography of Pediatric Moyamoya Disease Angioarchitecture in the Posterior Circulation

2014 ◽  
Vol 20 (4) ◽  
pp. 403-412 ◽  
Author(s):  
Gerasimos Baltsavias ◽  
Nadia Khan ◽  
Venko Filipce ◽  
Anton Valavanis
Keyword(s):  
Moyamoya Disease ◽  
Posterior Cerebral Artery ◽  
Posterior Circulation ◽  
Anterior Circulation ◽  
Feeding Vessels ◽  
Occlusive Lesion ◽  
Superselective Angiography ◽  
Anterior Choroidal ◽  
Premamillary Artery ◽  
Choroidal Artery

The anastomotic network of the posterior circulation in children with moyamoya disease has not been analyzed. We aimed to investigate the angiographic anatomy of this unique vascular network in patients with childhood moyamoya disease. Selective and superselective injections of the posterior circulation were performed in six children with newly diagnosed moyamoya disease. The arterial branches feeding the moyamoya anastomotic network, their connections and the recipient vessels were demonstrated. Depending on the level of the steno-occlusive lesion, the feeding vessels were the thalamoperforators, the posterior choroidals, the splenic artery, parietoccipital artery, other cortical posterior cerebral artery (PCA) branches, the dural branch of the PCA, the premamillary artery and other posterior communicating artery perforators. Through connections, which are described, the recipient vessels were the striate and medullary arteries, other thalamic arteries with or without medullary extensions, the pericallosal artery, medial parietoccipital cortical branches of the PCA and the anterior choroidal artery. High quality selective and superselective angiography helped in demonstrating the angiographic anatomy of the moyamoya posterior anastomotic network previously either vaguely or incompletely described, as well as connections within the posterior circulation but also its relevance as a collateral to the anterior circulation.

Focused post mortem dissection technique for harvest of rete mirabile in domestic swine (Sus scrofa)

2015 ◽  
Vol 8 (9) ◽  
pp. 973-976 ◽  
Author(s):  
Javed Khader Eliyas ◽  
Marek Niekrasz ◽  
Craig Wardrip ◽  
Seon-Kyu Lee
Keyword(s):  
Cerebral Arteries ◽  
Posterior Pharyngeal Wall ◽  
Surgical Anatomy ◽  
Post Mortem ◽  
Pharyngeal Wall ◽  
Rete Mirabile ◽  
Surgical Devices ◽  
Superselective Angiography ◽  
Dissection Technique ◽  
Detailed Technique

BackgroundRete mirabile (RM) of the domestic pig is a popular animal model of arteriovenous malformations. The RM (Latin for ‘wonderful net)’ comprises the arterioarterial portal connecting ascending pharyngeal arteries and the internal carotid arteries, which exists in the skull base of even-toed ungulates. Although angiographic access of the RM is relatively easy, its post mortem procurement is complicated and its detailed technique has not been well described.ObjectiveTo present our focused post mortem dissection technique for undamaged and complete harvest of the RM.Materials and methodsFourteen domestic (40–70 lb (18–32 kg)) swine were used in this study. Angiographies were performed under general anesthesia in all animals. A 5F Berenstein catheter was used for angiography and a 014 microcatheter was used to obtain superselective angiography. A stepwise surgical dissection technique has been developed to efficiently harvest RM. Angiographic and surgical anatomy were also compared.ResultsThe RM was supplied by bilateral ascending pharyngeal arteries. Bilateral anterior cerebral arteries, middle cerebral arteries, and the basilar system were identified rostral to the RM. Our surgical dissection technique was developed during a project to streamline harvesting of the RM and a stepwise description is as follows: (1) decapitate the swine by removing the head through the plane of the occiput and C1 vertebral body; (2) remove the tongue and oropharynx via a ventral approach; (3) dissect through the posterior pharyngeal wall identifying bilateral tympanic bullae and the basisphenoid bone; and (4) remove the basisphenoid bone about one and half inches above the rostral end of the tympanic bullae to fully expose the rete.ConclusionsThe RM can be procured efficiently and effectively with our technique, without requiring any sophisticated surgical devices.

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