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Wu C, Dong X, Li Q, Liu S, He Y, Zhang Y, Zhang S. Changes of serum MMP-9, NSE, MPO levels and prognostic influencing factors in patients with intracranial aneurysm undergoing interventional embolization at different treatment timing. J Med Biochem 2024; 43:144-152. [PMID: 38496021 PMCID: PMC10943457 DOI: 10.5937/jomb0-44364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/08/2023] [Indexed: 03/19/2024] Open
Abstract
Background To analyzes the changes in serum levels of matrix metalloproteinase-9 (MMP-9), neuroenolase (NSE), myeloperoxidase (MPO) and prognostic factors in patients with intracranial aneurysm (IA) undergoing interventional embolization at different treatment times. Methods A retrospective analysis was made of 200 IA patients admitted to our department from January 2018 to June 2021 was performed. All patients underwent interventional embolization. According to the timing of surgery, the patients were divided into an early group (n=120, onset to surgery ≤72 h) and a delayed group (n=80, onset to surgery >72 h). The effect of embolization, complications and neurological deficit scale (NDS) scores were compared between the two groups. Serum MMP-9, NSE and MPO levels were compared before and after surgery, and the prognosis of all patients within 2 years after surgery was assessed by the Glasgow outcome scale (GOS) and divided accordingly into the good prognosis group (n=147) and the poor prognosis group (n=53) accordingly, and the prognostic factors influencing the patients were analyzed univariately and multifactorially.
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Affiliation(s)
- Chunmiao Wu
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Xingyu Dong
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Qiang Li
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Shengming Liu
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Yuhao He
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Yang Zhang
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
| | - Sunfu Zhang
- Chengdu Third Peopležs Hospital, Department of Neurosurgery, Chengdu, Sichuan, China
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Rahmatian A, Yaghoobpoor S, Tavasol A, Aghazadeh-Habashi K, Hasanabadi Z, Bidares M, Safari-kish B, Starke RM, Luther EM, Hajiesmaeili M, Sodeifian F, Fazel T, Dehghani M, Ramezan R, Zangi M, Deravi N, Goharani R, Fathi M. Clinical efficacy of endovascular treatment approach in patients with carotid cavernous fistula: A systematic review and meta-analysis. World Neurosurg X 2023; 19:100189. [DOI: 10.1016/j.wnsx.2023.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 03/31/2023] Open
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Abaunza-Camacho JF, Vergara-Garcia D, Madrinan-Navia H, Riveros WM, Caballero A. Onyx Embolization of an Indirect Carotid–Cavernous Fistula with Cortical Venous Reflux: Technical note. J Neurol Surg A Cent Eur Neurosurg 2022. [PMID: 35073584 DOI: 10.1055/s-0041-1741547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Abstract
Background Indirect carotid–cavernous fistulas (iCCFs) are shunts between meningeal branches of the internal carotid and/or the external carotid arteries and the cavernous sinus. They account for 83% of all carotid–cavernous fistulas (CCFs). Symptomatic iCCFs and those with increased risk of hemorrhage should be treated. Transvenous endovascular treatment is the preferred treatment modality. However, in complex cases, a combination of transarterial and transvenous approaches (multimodal treatment) is required.
Methods A middle-aged woman presented with signs of increased intraocular pressure, blurry vision, diplopia, left proptosis, chemosis, conjunctival injection, ptosis, and cranial nerve VI palsy. Imaging confirmed the presence of a Barrow type D and Thomas type 4 iCCF with cortical venous reflux (CVR).
Results The patient underwent transarterial and transvenous onyx embolization of the shunt, achieving a complete obliteration of the fistula. No complications occurred and the patient had a satisfactory postprocedural evolution.
Conclusion Multimodal onyx embolization is an effective option for the treatment of a complex symptomatic iCCF. If CVR is identified, these lesions should be promptly treated to prevent hemorrhage secondary to rupture.
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Affiliation(s)
- Juan Felipe Abaunza-Camacho
- Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogotá, Colombia
- Rosario University School of Medicine, Bogotá, Colombia
| | - David Vergara-Garcia
- Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogotá, Colombia
- Rosario University School of Medicine, Bogotá, Colombia
| | - Humberto Madrinan-Navia
- Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogotá, Colombia
- Rosario University School of Medicine, Bogotá, Colombia
| | - William Mauricio Riveros
- Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogotá, Colombia
- Rosario University School of Medicine, Bogotá, Colombia
| | - Alberto Caballero
- Department of Neurosurgery, Center for Research and Training in Neurosurgery (CIEN), Samaritana University Hospital, Bogotá, Colombia
- Rosario University School of Medicine, Bogotá, Colombia
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Texakalidis P, Tzoumas A, Xenos D, Rivet DJ, Reavey-Cantwell J. Carotid cavernous fistula (CCF) treatment approaches: A systematic literature review and meta-analysis of transarterial and transvenous embolization for direct and indirect CCFs. Clin Neurol Neurosurg 2021; 204:106601. [PMID: 33774507 DOI: 10.1016/j.clineuro.2021.106601] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/04/2021] [Accepted: 03/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Carotid Cavernous Fistulas (CCFs) are the result of an abnormal communication between the carotid artery and its branches and the venous system of the cavernous sinus. The mainstay of therapy for CCFs consists of transarterial or transvenous embolization, while other treatment options such as open surgery or radiosurgery are still utilized as second-line or adjuvant therapeutic options. OBJECTIVE Our aim was to systematically review and summarize available data regarding short- and long-term outcomes of all available treatment modalities for CCFs. METHODS This systematic review was conducted according to the PRISMA guidelines. A random effects model meta-analysis was conducted. RESULTS Fifty-seven studies comprising 1575 patients were included in this systematic review. Transarterial embolization for direct and indirect CCFs offered a complete obliteration rate of 93.93% (N = 589/627) and 81.51% (N = 119/146), respectively. Transvenous embolization for direct and indirect lesions achieved obliteration in 91.67% (N = 33/36) and 86.03% (N = 425/494) of patients, respectively. Comparison between transarterial and transvenous embolization did not reveal statistically significant differences in terms of fistula obliteration for direct (OR: 1.42; 95% CI: 0.23-8.90; I2 0.0%) and indirect CCFs (OR: 0.62; 95% CI: 0.31-1.23; I2 0.0%). CONCLUSIONS Endovascular embolization techniques are the preferred treatment modality for the management of CCFs. No differences were identified between transarterial and transvenous embolization by synthesizing studies with available data. Future prospective cohorts are warranted to compare the different materials and techniques implemented especially within the rapidly expanding realm of endovascular approaches.
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Affiliation(s)
| | - Andreas Tzoumas
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Xenos
- Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dennis J Rivet
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA
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Prasad SN, Singh V, Boruah DK, Phadke RV, Sharma K, Kannaujia V. Endovascular Management of Direct Carotid-Cavernous Fistula: Evolution of Cost Effective Sandwich Technique. J Neurosci Rural Pract 2020; 11:558-564. [PMID: 33144791 PMCID: PMC7595771 DOI: 10.1055/s-0040-1714447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective
There is a direct fistulous connection between the cavernous segment of the internal carotid artery and cavernous sinus in cases of direct carotid–cavernous fistula (CCF). Endovascular embolization is the mainstay of management in this condition. This study is about the evolution of endovascular treatment methods and the development of a cost-effective technique for embolization of direct CCF at a tertiary care center.
Materials and Methods
A retrospective analysis was performed of all the cases of direct type CCF embolized by endovascular techniques in our department from 2008 to 2018.Clinical follow-up of these patients was done at 1 week, 3 months, and 6 months.
Results
A total of 45 patients with 40 having a prior history of head trauma were included in this study. All cases were treated with a transarterial route except one which was treated with the transvenous approach. Detachable balloon
s
were used in 12 (26.67%) patients, only detachable coils in 14 cases (31.11%), both detachable balloons and coils in 9 cases (20%), and both detachable and push coils, that is, sandwich technique in 8 cases (17.78%). Parent arterial occlusion was performed in 10 patients (22.22%). There was complete resolution of chemosis and bruit in all the patients.
Conclusion
Endovascular treatment is the mainstay of management in direct CCF. Using more fibered thrombogenic coils in a sandwich manner decreases the cost of the treatment significantly.
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Affiliation(s)
- Surya N Prasad
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vivek Singh
- Department of Radiodiagnosis, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Deb K Boruah
- Department of Radiodiagnosis, Tezpur Medical College and Hospital, Tezpur, Assam, India
| | - Rajendra V Phadke
- Department of Radiodiagnosis, Apollo hospital, Lucknow, Uttar Pradesh, India
| | - Kumudini Sharma
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Vikas Kannaujia
- Department of Ophthalmology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Yeh CF, Chen YH, Lin MS, Huang CC, Hung CS, Meng SW, Lee CK, Kao HL. Carotid-cavernous fistula after endovascular intervention for chronic carotid artery total occlusion. Catheter Cardiovasc Interv 2017; 91:735-741. [DOI: 10.1002/ccd.27392] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/23/2017] [Accepted: 10/09/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Chih-Fan Yeh
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Yin-Hsien Chen
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Mao-Shin Lin
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Ching-Chang Huang
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Chi-Sheng Hung
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital; Taipei Taiwan
| | - Shih-Wei Meng
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital Hsinchu Branch; Hsinchu Taiwan
| | - Chih-Kuo Lee
- Division of Cardiology, Department of Internal Medicine; National Taiwan University Hospital Hsinchu Branch; Hsinchu Taiwan
| | - Hsien-Li Kao
- Department of Internal Medicine; National Taiwan University College of Medicine; Taipei Taiwan
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