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Cale M, Roelofs KA, Goldberg RA, Leibowitz S, Glasgow BJ, Rootman DB. Hyperostosis associated with orbital vascular malformation. Orbit 2024; 43:236-239. [PMID: 35850633 DOI: 10.1080/01676830.2022.2101129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 07/09/2022] [Indexed: 10/17/2022]
Abstract
A previously healthy adult male presented with a slowly enlarging orbital mass associated with 5 mm of non-pulsatile proptosis. On imaging, a soft tissue lesion with avid contrast enhancement and associated bony hyperostosis was noted. The lesion and hyperostotic bone were surgically debulked, and significant arterial bleeding was noted intraoperatively consistent with an arteriovenous malformation. Histopathologic analysis revealed a vascular malformation with enhanced microvasculature infiltrating the periosteum. While vascular lesions elsewhere in the body can be associated with skeletal changes, bony hyperostosis is a rare feature of orbital vascular malformations.
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Affiliation(s)
- Mario Cale
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Kelsey A Roelofs
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Robert A Goldberg
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Steven Leibowitz
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Ben J Glasgow
- Departments of Ophthalmology and Pathology and Laboratory Medicine, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
| | - Daniel B Rootman
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, University of California, Los Angeles, California, USA
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Craveiro Costa R, Schrempp Esteves C, Marques I, Castro Faria H. Complex pulmonary arteriovenous malformation in a boy aged 18 months. An Pediatr (Barc) 2024; 100:299-300. [PMID: 38458853 DOI: 10.1016/j.anpede.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 11/13/2023] [Indexed: 03/10/2024] Open
Affiliation(s)
- Ricardo Craveiro Costa
- Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Unidade Local de Saúde de Coimbra, Coimbra, Portugal; Centro del Niño y el Adolescente, Hospital CUF Descobertas, Lisboa, Portugal.
| | | | - Inês Marques
- Centro del Niño y el Adolescente, Hospital CUF Descobertas, Lisboa, Portugal
| | - Hugo Castro Faria
- Centro del Niño y el Adolescente, Hospital CUF Descobertas, Lisboa, Portugal; Unidad de Cuidados Intermedios Pediátricos y del Adolescente, Hospital CUF Descobertas, Lisboa, Portugal
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Hayashida Y, Murakami Y, Fukumitsu S, Yoshimatsu Y, Anai K, Todoroki Y, Fujisaki A, Ide S, Aoki T. Feasibility of Breath-Hold Zero TE Magnetic Resonance Imaging Sequence for Evaluation of Pulmonary Arteriovenous Malformations After Embolotherapy. J Comput Assist Tomogr 2024; 48:233-235. [PMID: 38110292 DOI: 10.1097/rct.0000000000001568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
ABSTRACT We obtained breath-hold zero TE (ZTE) magnetic resonance imaging for the evaluation of pulmonary arteriovenous malformations before and after embolotherapy. To the best of our knowledge, there have been no reports of ZTE for the entire lung imaging in single breath-hold scan time such as 20 seconds. Breath-hold ZTE magnetic resonance imaging can be a useful technique for magnetic resonance-based follow-up of vascular lung diseases without using contrast media, reducing the undesired artifacts from metallic devices.
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Affiliation(s)
- Yoshiko Hayashida
- From the Department of Radiology, University of Occupational and Environmental Health, Fukuoka, Japan
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Latif MA, Bailey C, Weiss CR. Persistence After Treatment of Pulmonary Arteriovenous Malformations in Children. Cardiovasc Intervent Radiol 2024; 47:394-396. [PMID: 38062174 DOI: 10.1007/s00270-023-03625-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 11/14/2023] [Indexed: 03/09/2024]
Affiliation(s)
- Muhammad A Latif
- Russell H. Morgan Department of Radiology and Radiological Science, Interventional Radiology Center, The Johns Hopkins University School of Medicine, 7203 Sheikh Zayed Tower, Suite 7, 1800 Orleans Street, Baltimore, MD, 21287, USA
- Division of Nuclear Medicine, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Christopher Bailey
- Russell H. Morgan Department of Radiology and Radiological Science, Interventional Radiology Center, The Johns Hopkins University School of Medicine, 7203 Sheikh Zayed Tower, Suite 7, 1800 Orleans Street, Baltimore, MD, 21287, USA
| | - Clifford R Weiss
- Russell H. Morgan Department of Radiology and Radiological Science, Interventional Radiology Center, The Johns Hopkins University School of Medicine, 7203 Sheikh Zayed Tower, Suite 7, 1800 Orleans Street, Baltimore, MD, 21287, USA.
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5
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Hollman D, Alzahrani F, Fiorillo L, Thompson A, Mahmood MN. Arteriovenous malformation with hair collar sign. Pediatr Dermatol 2024; 41:346-347. [PMID: 38085129 DOI: 10.1111/pde.15482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/04/2023] [Indexed: 03/19/2024]
Abstract
We report the case of a newborn who was noted at birth to have an occipital scalp nodule presenting with a hair collar sign (HCS). The nodule had enlarged since birth. An MRI revealed a soft tissue mass on the occipital scalp without deep extension or cranial bone involvement. A biopsy of the nodule led to a diagnosis of arteriovenous malformation (AVM). A vascular malformation with HCS has not been reported before in North America. This case highlights the complexity of diagnosing a lesion with a hair collar sign.
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Affiliation(s)
- Dylan Hollman
- Katz Group Centre for Pharmacy & Health Research, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Fatmah Alzahrani
- Division of Dermatology, Phoenix Children's Hospital, Phoenix, Arizona, USA
- Department of Dermatology, Mayo Clinic College of Medicine and Science, Phoenix, Arizona, USA
| | - Loretta Fiorillo
- Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada
| | - Adrienne Thompson
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
- Division of Radiology, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Muhammad N Mahmood
- Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada
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Adams RC, Hegde S, Sutphin P, Iqbal S, Irani Z, Kalva SP. Use of Polyurethane-Covered Stents for Exclusion of Pulmonary Arteriovenous Malformations. Cardiovasc Intervent Radiol 2024; 47:360-365. [PMID: 38180506 DOI: 10.1007/s00270-023-03638-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE To evaluate the safety, technical success and short-term effectiveness of polyurethane-covered stent (PK Papyrus, BioTronik, Berlin) in the treatment of pulmonary arteriovenous malformations (PAVMs) that are not amenable to embolotherapy. MATERIALS AND METHODS In this IRB-approved, retrospective study, data from patients who received polyurethane-covered stents for exclusion of PAVMs were analyzed. The study included 5 patients (all women) with a median age of 40 years (range 25-60). Patients presented with hypoxemia, TIAs, and/or epistaxis; 4 were confirmed to have HHT. All had multiple PAVMs diagnosed on chest CT and underwent embolization with other devices in addition to the polyurethane-covered stent. The indication for stent placement in all cases was a short and/or tortuous feeding artery. Safety was assessed by immediate or short-term complications, e.g., migration, stent thrombosis, and fracture. Technical success was defined as the ability to accurately place the stent at the intended location. Effectiveness was defined as successful exclusion of PAVM with no perfusion across the AVM. RESULTS Technical success of stent placement was 100%. AVM exclusion rate was 80% after single stent deployment; in the case of incomplete exclusion, success was achieved using an overlapping stent to completely cover a second feeding artery. During the median follow-up period of 5 months (range 2-10), all stents remained patent, and AVMs were excluded without other complications. CONCLUSION Exclusion of PAVMs with polyurethane-covered stents is technically feasible, safe, and shows short-term effectiveness for PAVMs with a short/tortuous feeding artery when traditional embolization techniques are not possible.
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Affiliation(s)
- Ryan C Adams
- Interventional Radiology Division, Radiology Department, Massachusetts General Hospital, Boston, MA, USA.
| | - Siddhi Hegde
- Abdominal Radiology Division, Radiology Department, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick Sutphin
- Interventional Radiology Division, Radiology Department, Massachusetts General Hospital, Boston, MA, USA
| | - Shams Iqbal
- Interventional Radiology Division, Radiology Department, Massachusetts General Hospital, Boston, MA, USA
| | - Zubin Irani
- Interventional Radiology Division, Radiology Department, Massachusetts General Hospital, Boston, MA, USA
| | - Sanjeeva P Kalva
- Interventional Radiology Division, Radiology Department, Massachusetts General Hospital, Boston, MA, USA
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Gong AJ, Bosworth EC, Garg T, Weiss CR. Prospective Study of Polytetrafluoroethylene-Covered Microplugs and Detachable Coils for Embolization of Pulmonary Arteriovenous Malformations: Technical Results, Procedure Times, and Costs. J Vasc Interv Radiol 2024; 35:362-369. [PMID: 38123126 DOI: 10.1016/j.jvir.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 11/17/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To determine time to occlusion and procedure costs of embolization of pulmonary arteriovenous malformations (PAVMs) using a polytetrafluoroethylene-covered microplug compared with embolization using detachable coils. MATERIALS AND METHODS In this prospective study, 37 patients (mean age, 39.1 years [SD ± 17.6]) with 82 PAVMs underwent embolization with microplug or detachable coils between April 2019 and January 2023. Technical success, procedure time intervals, and costs were analyzed. RESULTS In 37 patients, 82 PAVMs and 101 feeding arteries were successfully treated (microplug, 64; microplug + another device, 5; detachable coils alone, 32). Time from embolic device inserted into the catheter to device deployed and time to occlusion differed significantly between microplug and detachable coil cohorts (P < .0001 for both). Embolization with ≥1 microplug had a significantly shorter occlusion time than embolization with detachable coils (median, 10.0 minutes saved per feeding artery) (P < .0001). Compared with detachable coil embolization, microplug embolization saved a median of 9.0 minutes per feeding artery (P < .0001) and reduced room cost by a median of $429 per feeding artery (P < .0001). Device costs per feeding artery did not differ significantly between microplug ($2,790) and detachable coil embolization ($3,147) (P = .87). CONCLUSIONS Compared with coils, microplugs had an equally high technical success rate but significant time to occlusion and room costs savings per feeding artery. Total room cost and device cost together did not differ significantly between microplugs and coils. Microplugs may be considered technically effective and at least cost-neutral for PAVM embolization where clinically appropriate.
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Affiliation(s)
- Anna J Gong
- Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Eugene C Bosworth
- Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tushar Garg
- Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Clifford R Weiss
- Russell H. Morgan Department of Radiology and Radiological Science, the Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Tanaka K, Osuga K, Nagai K, Satomura H, Tomotake K, Koretsune Y, Kimura Y, Ono Y, Higashihara H, Tomiyama N. Four Cases of Delayed Pneumonia Around Coils After Embolization of Pulmonary Arteriovenous Malformations. Cardiovasc Intervent Radiol 2024; 47:397-400. [PMID: 38087054 DOI: 10.1007/s00270-023-03588-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/05/2023] [Indexed: 03/09/2024]
Affiliation(s)
- Kaishu Tanaka
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
| | - Keigo Osuga
- Department of Diagnostic Radiology, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, Japan
| | - Keisuke Nagai
- Department of Radiology, Toyonaka Municipal Hospital, 1-14-4 Shibahara-Cho, Toyonaka, Osaka, Japan
| | - Hiroki Satomura
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Kosuke Tomotake
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Yuji Koretsune
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Yasushi Kimura
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Yusuke Ono
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Hiroki Higashihara
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
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Botsford A, Tradi F, Loubet A, Tantawi S, Soulez G, Giroux MF, Faughnan ME, Gauthier A, Perreault P, Bouchard L, Holderbaum do Amaral R, Chartrand-Lefebvre C, Therasse E. Transarterial Embolization of Simple Pulmonary Arteriovenous Malformations: Long-Term Outcomes of 0.018-Inch Coils versus Vascular Plugs. J Vasc Interv Radiol 2024; 35:349-360. [PMID: 38013007 DOI: 10.1016/j.jvir.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 10/24/2023] [Accepted: 11/17/2023] [Indexed: 11/29/2023] Open
Abstract
PURPOSE To compare the safety, effectiveness, and persistence rates of 0.018-inch coils with those of Amplatzer vascular plugs (AVPs; Abbott Vascular, Abbott Park, Illinois) for the treatment of pulmonary arteriovenous malformations (PAVMs) in response to a growing concern that 0.018-inch coil embolization would increase the long-term persistence rate. MATERIALS AND METHODS This is a retrospective, single-center study of a database (2002-2020) of 633 PAVM embolizations. Complex PAVMs and those not embolized with 0.018-inch coils or plugs were excluded. PAVM embolization material was classified into 4 groups: (a) 0.018-inch nonfibered coils (NFCs), (b) 0.018-inch fibered coils (FCs), (c) NFCs and FCs, or (d) plugs. Persistence was defined as flow through the PAVM on digital subtraction angiography (DSA) or as <30% diameter reduction of the aneurysmal sac on unenhanced computed tomography (CT). Kaplan-Meier analysis and Cox regression were used to assess PAVM's persistence-free survival. RESULTS A total of 312 PAVM embolizations with NFCs (43 PAVMs), FCs (127 PAVMs), NFCs and FCs (12 PAVMs), or plugs (130 PAVMs) in 109 patients (28% men; mean age = 49 years) were included. All PAVM embolizations were technically successful without any major adverse events. PAVM persistence-free survival rates at 10 years' follow-up were 40.8% versus 44.7% in the NFC and FC groups (P = .22) and 47.3% versus 81.0% in the 0.018-inch coil (NFC or FC) and plug groups (P < .0001), respectively. There were 0.43 (79/182) and 0.08 (10/130) re-embolization procedures per PAVM in the 0.018-inch coil and plug groups, respectively (P < .001). CONCLUSIONS PAVM embolization with 0.018-inch coils was safe, but persistence rate with PAVM embolization was significantly higher than that with plugs, with no significant differences between FCs and NFCs.
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Affiliation(s)
- Alexander Botsford
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada; Department of Radiology, QEII Health Sciences Centre, Halifax, Nova Scotia, Canada
| | - Farouk Tradi
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada; Assistance publique-hôpitaux de Marseille, Hôpital de la Timone, Service d'imagerie diagnostic et interventionnelle, Marseille, France; Laboratoire d'imagerie interventionnelle expérimentale (LIIE), Faculté de Médecine, CERIMED, Université Aix-Marseille Marseille, France
| | - Antoine Loubet
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada; Department of Radiology, Université de Montpellier, France
| | - Suhad Tantawi
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
| | - Gilles Soulez
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada; Centre de recherche du CHUM (CRCHUM), Pavillon R, Montréal Quebec, Canada
| | - Marie-France Giroux
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
| | - Marie E Faughnan
- Montreal HHT Centre, Division of Pneumology, Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, Quebec, Canada; Division of Respirology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; St. Michael's Hospital and Li Ka Shing Knowledge Institute Toronto, Ontario, Canada
| | - Andréanne Gauthier
- Montreal HHT Centre, Division of Pneumology, Centre Hospitalier de l'Université de Montreal (CHUM), Montreal, Quebec, Canada
| | - Pierre Perreault
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
| | - Louis Bouchard
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
| | | | - Carl Chartrand-Lefebvre
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada
| | - Eric Therasse
- Department of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Quebec, Canada; Centre de recherche du CHUM (CRCHUM), Pavillon R, Montréal Quebec, Canada.
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Otsuji R, Kasai H, Sugiura T, Suzuki H, Suzuki T. Evaluation of a gradually enlarging complex pulmonary arteriovenous malformation consisting of innumerable small fistulae using four-dimensional computed tomography. BMJ Case Rep 2024; 17:e258200. [PMID: 38367987 PMCID: PMC10875502 DOI: 10.1136/bcr-2023-258200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2024] Open
Affiliation(s)
- Ruka Otsuji
- Department of Medicine, School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Hajime Kasai
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
| | - Toshihiko Sugiura
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
| | - Hidemi Suzuki
- Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Takuji Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan
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Jiang C, You J, Wang J. Treatment of a Pathologic Radial Fracture Associated with an Arteriovenous Malformation Using Sclerotherapy and Cementoplasty. J Vasc Interv Radiol 2024; 35:318-320.e2. [PMID: 37806349 DOI: 10.1016/j.jvir.2023.09.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/20/2023] [Accepted: 09/28/2023] [Indexed: 10/10/2023] Open
Affiliation(s)
- Chunyu Jiang
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhi Zao Ju Rd., Shanghai 200233, People's Republic of China
| | - Jianxiong You
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhi Zao Ju Rd., Shanghai 200233, People's Republic of China
| | - Jingbing Wang
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No. 639 Zhi Zao Ju Rd., Shanghai 200233, People's Republic of China.
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12
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Grill N, Struebing F, Weiss C, Schönberg SO, Sadick M. Management of congenital urogenital and perineal vascular malformations: correlation of clinical findings with diagnostic imaging for treatment decision. ROFO-FORTSCHR RONTG 2024; 196:186-194. [PMID: 37922942 DOI: 10.1055/a-2127-4132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
PURPOSE Analysis of clinical and diagnostic findings in rare urogenital and perineal vascular malformations only occurring in 2-3 % of vascular anomalies with regard to clinical symptoms and treatment decisions. MATERIALS AND METHODS All 25 out of 537 patients presenting with congenital urogenital and perineal vascular malformations at our institution from 2014 to 2021 were included. Vascular anomaly classification, anatomical location, clinical symptoms at presentation, diagnostic imaging, and pain intensity were retrospectively assessed from the patient record and therapy management was evaluated. RESULTS In total, 25 patients (10 females (40 %), 15 males (60 %)), aged 6 to 77 years were included. Diagnoses were: 10 (40 %) venous malformations (VMs), 5 (20 %) lymphatic malformations (LMs) and 10 (40 %) arteriovenous malformations (AVMs). Malformation manifestations were: 12 (32 %) lesser pelvis, 12 (32 %) external genitalia, and 13 (34 %) perineal/gluteal region. One AVM was located in the kidney. The leading clinical symptom was pain. The mean intensity was 6.0/10 for LM, 5.7/10 for VM, and 4.5/10 for AVM. Further major symptoms included physical impairment, local swelling, and skin discoloration. Bleeding complications or sexual dysfunction were rare findings. Patients with VM reported significantly more symptoms than patients with AVM (p = 0.0129). In 13 patients (52 %) minimally invasive therapy was indicated: 10 (77 %) sclerotherapies and 3 (23 %) transcatheter embolization procedures. Complete symptomatic remission was achieved in 9 (69 %) patients, partial response in 3 (23 %) patients, and 1 patient showed no clinical response to therapy. Follow-up appointments without the need for immediate minimally invasive therapy were significantly more common in patients with AVMs than in patients with VMs (p = 0.0198). CONCLUSION To create a higher awareness of congenital urogenital and perineal vascular malformations. Awareness of this rare condition avoids misdiagnosis. Therapy decisions should be symptom-oriented. Emergency intervention is rarely required, even in fast-flow vascular malformations. KEY POINTS · Venous malformations cause more symptoms with higher pain intensity than arteriovenous malformations.. · Diagnosis and adequate treatment can be hampered by a lack of awareness of the clinical presentation.. · Bleeding complications are rare, even in high-flow vascular malformations.. · Pain and physical impairment are the most commonly observed symptoms in these patients..
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Affiliation(s)
- Nadja Grill
- Clinic for Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Felix Struebing
- Department of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Centre Ludwigshafen, Germany
| | - Christel Weiss
- Department of Medical Statistics, Biomathematics and Information Processing, Medical Faculty Mannheim, Ruprecht-Karls-University of Heidelberg, Heidelberg, Mannheim, Germany
| | - Stefan O Schönberg
- Clinic for Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
| | - Maliha Sadick
- Clinic for Radiology and Nuclear Medicine, University Medical Centre Mannheim, Germany
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13
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Ethunandan M. Management of Midfacial and Skull Vault Osseous Vascular Lesions. Oral Maxillofac Surg Clin North Am 2024; 36:61-72. [PMID: 37821289 DOI: 10.1016/j.coms.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
There continuous to be widespread misuse of nomenclature used to described vascular anomalies, This is even more pronounced in the case of intra-osseous lesions. Bone involvement is more common with vascular malformations and extremely rare in haemangiomas. An accurate diagnosis is mandatory for tailored management and often based on a thorough history, clinical examination, and cross-sectional imaging. Surgery remains the main stay for the management of symptomatic venous malformations. Embolisation with or without surgery is the main stay for arteriovenous malformations. Virtual surgical planning, with surgical guides and patient specific implants help achieve predictably excellent results.
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Affiliation(s)
- Madan Ethunandan
- Oral & Maxillofacial Surgery, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK; Oral & Maxillofacial Surgery, Sri Ramchandra Institute of Higher Education and Research, Prour, Chennai, 600116, India.
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14
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Shaikh A, Khan A, Mohsin F, Haq TU. Fetal choroid plexus arteriovenous malformation, masquerading as a neoplastic lesion. BMJ Case Rep 2024; 17:e258254. [PMID: 38199667 PMCID: PMC10806836 DOI: 10.1136/bcr-2023-258254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024] Open
Abstract
A woman in her 20s, who was pregnant, underwent a routine antenatal ultrasound revealing organised intraventricular haemorrhage and a vascular area in the left thalamic region. Fetal MRI raised suspicion of arteriovenous malformation (AVM). The baby was delivered at 36 weeks via C-section, and initial brain MRI suggested a possible neoplastic lesion.Cerebral angiography confirmed a large AVM involving the left choroid plexus with arterial feeders from the left anterior and posterior choroidal arteries and a large venous varix draining into the vein of Galen. Both arterial feeders were successfully embolised with Onyx and glue, achieving complete occlusion.Choroid plexus AVMs are rare and often lead to intraventricular or intraparenchymal haemorrhage. Surgical treatment has shown success, but endovascular management is effective, especially for small, deep-seated AVMs, offering a better prognosis.
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Affiliation(s)
| | - Anam Khan
- Aga Khan University, Karachi, Pakistan
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15
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Mehlhorn I, Heichel J, Wohlgemuth W, Skalej M, Izaguirre V, Dießel L, Kisser U, Viestenz A, Wienrich R. [Interdisciplinary management of a combined vascular malformation of the orbit]. Ophthalmologie 2024; 121:68-71. [PMID: 37624390 DOI: 10.1007/s00347-023-01900-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/02/2023] [Accepted: 07/03/2023] [Indexed: 08/26/2023]
Affiliation(s)
- Ivana Mehlhorn
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland.
| | - Jens Heichel
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Walter Wohlgemuth
- Klinik und Poliklinik für Radiologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Martin Skalej
- Klinik und Poliklinik für Radiologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Victor Izaguirre
- Klinik und Poliklinik für Strahlentherapie und Radioonkologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Linda Dießel
- Institut für Pathologie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Ulrich Kisser
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Kopf- und Halschirurgie, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Arne Viestenz
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
| | - Ricarda Wienrich
- Klinik und Poliklinik für Augenheilkunde, Martin-Luther-Universität Halle-Wittenberg, Halle, Deutschland
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16
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Hsu JT, Hsieh SJ, Chang CY. Renal arteriovenous malformation: A rare and potentially life-threatening cause of hematuria. Asian J Surg 2024; 47:716-717. [PMID: 37914644 DOI: 10.1016/j.asjsur.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023] Open
Affiliation(s)
- Jen-Ting Hsu
- Division of Urology Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Shang-Ju Hsieh
- Division of Urology Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chao-Yuan Chang
- Division of Urology Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Program in Nutrition and Food Science, Graduate Institute of Biomedical and Pharmaceutical Science, Fu Jen Catholic University, New Taipei City, Taiwan.
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17
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Dewilde K, Groszmann Y, Van Schoubroeck D, Grewal K, Huirne J, de Leeuw R, Bourne T, Timmerman D, Van den Bosch T. Enhanced myometrial vascularity secondary to retained pregnancy tissue: time to stop misusing the term arteriovenous malformation. Ultrasound Obstet Gynecol 2024; 63:5-8. [PMID: 37676250 DOI: 10.1002/uog.27476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/21/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023]
Affiliation(s)
- K Dewilde
- Department of Obstetrics & Gynecology, University Hospital Leuven, Leuven, Belgium
| | - Y Groszmann
- Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - D Van Schoubroeck
- Department of Obstetrics & Gynecology, University Hospital Leuven, Leuven, Belgium
| | - K Grewal
- Early Pregnancy and Acute Gynaecology Unit, Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
| | - J Huirne
- Department of Obstetrics and Gynecology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - R de Leeuw
- Department of Obstetrics and Gynecology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - T Bourne
- Early Pregnancy and Acute Gynaecology Unit, Department of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, Imperial College London, London, UK
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - D Timmerman
- Department of Obstetrics & Gynecology, University Hospital Leuven, Leuven, Belgium
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
| | - T Van den Bosch
- Department of Obstetrics & Gynecology, University Hospital Leuven, Leuven, Belgium
- Department of Development & Regeneration, KU Leuven, Leuven, Belgium
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18
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Yu Q, Zangan S, Funaki B. Preliminary Experience with a Low-Profile High-Density Braid Occluder for Transcatheter Embolization of Pulmonary Arteriovenous Malformations. J Vasc Interv Radiol 2024; 35:32-35.e2. [PMID: 37748577 DOI: 10.1016/j.jvir.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 09/27/2023] Open
Abstract
This brief report describes safety, technical feasibility, and early treatment effectiveness of the low-profile braided occluder (LOBO; Okami Medical, San Diego, Caliornia) for embolization of 9 pulmonary arteriovenous malformations (PAVMs) in 4 patients (3 female and 1 male; age range: 33 to 63 years; 3 patients showed positive results for hereditary hemorrhagic telangiectasia genes). A total of 10 occluders were deployed in 10 vessels (median treated vessel diameters, 3 and 4 mm for LOBO-3 and LOBO-5 groups, respectively). All devices were successfully deployed into the feeder pulmonary arteries, achieving complete cessation of flow. There were no severe adverse events or device migrations. Available short-term follow-up computed tomography (6 PAVMs: median, 7 months; range, 1.5-7 months) demonstrated complete occlusion without persistence or recanalization. The early experience of embolization of PAVMs using a low-profile braided occluder showed it to be safe and effective. Further studies with larger cohorts and longer follow-up periods are warranted.
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Affiliation(s)
- Qian Yu
- Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois.
| | - Steven Zangan
- Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois
| | - Brian Funaki
- Department of Radiology, University of Chicago Medical Center, University of Chicago, Chicago, Illinois
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19
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Chaluvashetty SB, Chowhan PS, Bhandari RM, Shah J. Adnexal arteriovenous malformation presenting with spontaneous massive haemoperitoneum. BMJ Case Rep 2023; 16:e254554. [PMID: 38056929 PMCID: PMC10711873 DOI: 10.1136/bcr-2023-254554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
Arteriovenous malformations (AVMs) are vascular anomalies composed of a tangle of abnormal vessels in which one or more feeding arteries are directly connected to one or more draining veins via a nidus with no intervening capillary bed. The adnexa are particularly rare sites for the formation of such malformations. Here, we present the case of a middle-aged woman who presented with spontaneous massive haemoperitoneum occurring as a result of a ruptured adnexal AVM. The diagnosis was suspected on transabdominal sonography and confirmed on CT angiography. The patient was shifted to the interventional radiology suite for an urgent angioembolisation following which she improved haemodynamically and her symptoms resolved. The case highlights the fact that although exceedingly rare, gonadal AVMs are an important cause of spontaneous intraperitoneal bleeding. Diagnostic and interventional radiology play an important role in the early and accurate diagnosis of this entity, and angioembolisation can be lifesaving in such patients.
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Affiliation(s)
- Sreedhara B Chaluvashetty
- Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Prabhjyot Singh Chowhan
- Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajan Mani Bhandari
- Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jimil Shah
- Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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20
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Ham PB, Anderson SR, Neff LP, Osei H, Gill AE, Hawkins CM, Jose J, Bhatia AM. Percutaneous Embolization and Laparoscopic Ligation of a Congenital Umbilical Arteriovenous Malformation. Am Surg 2023; 89:6278-6281. [PMID: 36629251 DOI: 10.1177/00031348221148348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Phillip Benson Ham
- Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, GA, USA
- Division of Pediatric Surgery, John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - Spencer R Anderson
- Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, GA, USA
- Department of Plastics and Reconstructive Surgery, Wright State University School of Medicine, Dayton, OH, USA
| | - Lucas P Neff
- Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, GA, USA
| | - Hector Osei
- Division of Pediatric Surgery, John R. Oishei Children's Hospital, Buffalo, NY, USA
| | - Anne E Gill
- Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Pediatric Radiology, Emory + Children's Pediatric Institute, Children Healthcare of Atlanta, Atlanta, GA, USA
| | - Clifford M Hawkins
- Division of Interventional Radiology and Image Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Pediatric Radiology, Emory + Children's Pediatric Institute, Children Healthcare of Atlanta, Atlanta, GA, USA
| | - Jeremy Jose
- Philadelphia College of Osteopathic Medicine, Suwanee, GA, USA
| | - Amina M Bhatia
- Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Children's Healthcare of Atlanta, GA, USA
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21
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Tan I, Toh L. Abnormal uterine bleeding due to uterine arteriovenous malformation in an early adolescent with intrauterine contraceptive device in situ. BMJ Case Rep 2023; 16:e258241. [PMID: 38050399 PMCID: PMC10693851 DOI: 10.1136/bcr-2023-258241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
We report a case of uterine arteriovenous malformation in an early adolescent who presented with heavy vaginal bleeding 2 months after termination of pregnancy with copper intrauterine contraceptive device (IUCD) insertion. The patient was admitted and had medical treatment, including blood transfusion and subsequently transcatheter embolisation of the arteriovenous malformation to control her bleeding. The IUCD was left in situ. Her symptoms completely resolved by 4 months post-procedure.
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Affiliation(s)
- Ilka Tan
- Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore
| | - Luke Toh
- Radiology, KK Women's and Children's Hospital, Singapore
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22
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Yamazaki D, Hanaoka Y, Koyama JI, Suzuki Y, Agata M, Abe D, Nakamura T, Fujii Y, Ogiwara T, Horiuchi T. Intraspinal canal platform system for coil embolization of anterior spinal artery aneurysm associated with spinal cord arteriovenous malformation: a case report and literature review. Br J Neurosurg 2023; 37:1786-1791. [PMID: 33851560 DOI: 10.1080/02688697.2021.1910201] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/25/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND The prognosis for spinal artery aneurysms associated with spinal cord arteriovenous malformations (AVMs) is poor because of the high rupture rate of aneurysms. However, endovascular treatment remains technically difficult because the catheter system must be constructed via the small-caliber anterior spinal artery (ASA) or posterior spinal artery (PSA), which feeds functionally eloquent spinal cord. A 2.6F Carnelian HF-S microcatheter (Tokai Medical Products, Aichi, Japan) has been specifically designed to assist a 1.6F Carnelian MARVEL S microcatheter (Tokai Medical Products) as a small-profile 'platform catheter' close to the target lesion. Here we present a prenidal ASA aneurysm treated using a 2.6F Carnelian HF-S microcatheter as an intraspinal canal platform catheter and review related literature. CASE PRESENTATION A 50-year-old man presented with a subarachnoid haemorrhage due to cervical spinal cord AVM. Diagnostic vertebral angiography revealed the AVM supplied by the PSA originated from the right C2 segmental artery and ASA arising from the right V4 segment. Superselective angiography for each feeder was achieved through a 2.6F Carnelian HF-S microcatheter, and a prenidal ASA aneurysm was diagnosed, which was clinically consistent with haemorrhagic origin. A 1.6F Carnelian MARVEL S microcatheter was cannulated into the aneurysm through the 2.6F Carnelian HF-S microcatheter positioned at the ASA. The aneurysm coiling was successfully performed without system instability or periprocedural complications. CONCLUSIONS Only a few cases have described endovascular treatment for spinal artery aneurysms. To date, no reports have been published regarding the use of an intraspinal canal platform catheter to treat spinal artery aneurysms. A 2.6F Carnelian HF-S microcatheter served as a useful intraspinal canal platform catheter for coil embolization of the ASA aneurysm. This system can provide excellent accessibility and controllability for endovascular treatment of spinal artery lesions.
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Affiliation(s)
- Daisuke Yamazaki
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshiki Hanaoka
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Jun-Ichi Koyama
- Neuroendovascular Therapy Center, Shinshu University Hospital, Matsumoto, Japan
| | - Yota Suzuki
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masahiro Agata
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Daishiro Abe
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takuya Nakamura
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yu Fujii
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toshihiro Ogiwara
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tetsuyoshi Horiuchi
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan
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23
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Nguyen TH, Tran LT, Nguyen BC, Dinh NT, Mai HT, Pham QNM, Van Ho L, Ky TD, Nguyen TL. Rare Cause of Gastrointestinal Bleeding: A Case Report of Pancreatic Arteriovenous Malformation. Am J Case Rep 2023; 24:e941638. [PMID: 37995202 PMCID: PMC10684828 DOI: 10.12659/ajcr.941638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 10/18/2023] [Accepted: 10/05/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Arteriovenous malformation is an unusual cause of gastrointestinal bleeding, particularly in the pancreas. A definitive treatment strategy is not yet established. CASE REPORT We present the case of a 37-year-old man with underlying hypertension and no significant family history who presented with a 3-month history of intermittent epigastric pains and unintentional weight loss of 5 kg in 2 months. The upper endoscopy showed a large duodenal ulcer, which was uncontrolled with a standard dose of proton pump inhibitors. An abdominal computed tomography scan with contrast was indicated and revealed an enhanced mass of 2.5×3.5×4 cm in size, located on the second and third parts of the duodenum and head of the pancreas, indicating an arteriovenous malformation. On day 10 of hospitalization, the patient suddenly had melena and a drop of hemoglobin level to 5.6 g/dL; angiography intervention was successful to control the bleeding. However, gastrointestinal bleeding recurred after 2 weeks, and the patient successfully underwent a Whipple procedure. CONCLUSIONS The diagnosis and therapeutic management of arteriovenous malformations are uniquely challenging; therefore, pancreatic arteriovenous malformations should be listed on the differential diagnosis, particularly in those cases with non-healing and large duodenal ulcers. Otherwise, early imaging modalities should be performed to confirm the diagnosis. In particular, angiography can temporarily control bleeding before proceeding with more definitive therapy.
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Affiliation(s)
- Thanh Huu Nguyen
- Department of Internal Medicine, College of Health Sciences, VinUniversity, Hanoi, Vietnam
| | - Lam Tung Tran
- Department of Gastrointestinal, 108 Military Central Hospital, Hanoi, Vietnam
| | - Binh Canh Nguyen
- Department of Gastrointestinal, 108 Military Central Hospital, Hanoi, Vietnam
| | - Nga Thi Dinh
- Department of Gastrointestinal, 108 Military Central Hospital, Hanoi, Vietnam
| | - Hoai Thu Mai
- Department of Gastrointestinal, 108 Military Central Hospital, Hanoi, Vietnam
| | | | - Linh Van Ho
- Department of Surgical Gastroenterology, 108 Military Central Hospital, Hanoi, Vietnam
| | - Thai Doan Ky
- Department of Gastrointestinal, 108 Military Central Hospital, Hanoi, Vietnam
| | - Tung Lam Nguyen
- Department of Gastrointestinal, 108 Military Central Hospital, Hanoi, Vietnam
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Chen J, Dou J, Han Z, Liang P. Microwave Ablation for Refractory Giant Maxillofacial Arteriovenous Malformation: A Case Report. Laryngoscope 2023; 133:2984-2987. [PMID: 36960915 DOI: 10.1002/lary.30664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 01/31/2023] [Accepted: 02/21/2023] [Indexed: 03/25/2023]
Abstract
Maxillofacial arteriovenous malformation located in the sensitive parts of the nose and lips has been an arduous challenge for doctors to meet a balance between resection and aesthetics in one time. In this report, one patient with a giant arteriovenous malformation covering the forehead, the nose, the lip, and bilateral cheeks and resulting in the appearance of the face like a lion's face, can not meet satisfactory outcomes by other therapeutic methods. We successfully reduced the size of vascular lesion using low-power and short-duration microwave ablation under real-time ultrasound guidance. In the two-year follow-up, the patient's face almost recovered to normality. Microwave ablation is expected to be a new alternative therapy for the treatment of maxillofacial arteriovenous malformations. Laryngoscope, 133:2984-2987, 2023.
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Affiliation(s)
- Jiye Chen
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jianping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhiyu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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25
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Shen Y, Wang D, Wen M, Di R, Fan X, Su L, Yang X. Coil-assisted ethanol embolotherapy for refractory head and neck arteriovenous malformations with Onyx recrudescence: 10-Year experiences. J Vasc Surg Venous Lymphat Disord 2023; 11:1219-1230. [PMID: 37473869 DOI: 10.1016/j.jvsv.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/29/2023] [Accepted: 07/09/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE This study aimed to evaluate the outcomes of coil-assisted ethanol embolotherapy in recanalized head and neck arteriovenous malformations (HNAVMs) with dilated outflowing veins after Onyx treatment. METHODS Thirty-six patients with HNAVMs (18 females and 18 males with a mean age of 26.83 years) who experienced recurrence after Onyx embolization from October 2007 to October 2017 were included in this study. All patients underwent complete clinical and angiographic examinations. Further, each patient was classified based on the Schobinger stage before undergoing staged ethanol embolization. All patients were followed up for 5 years in-person at an interval of 3 months after discharge. The Kaplan-Meier method was used to perform the recurrence-free survival analysis. RESULTS Sixteen patients (44.4%) had Schobinger stage II HNAVMs, and the remaining patients had Schobinger stage III or IV (20/36 patients [55.6%]) HNAVMs. A total of 116 embolization procedures were performed, coils were applied in 107 procedures (92.2%) among patients with dilated outflowing veins. The dose of absolute ethanol was 16.39 mL per procedure in patients with Schobinger II HNAVMs, and 22.45 mL per procedure in patients with Schobinger III and IV HNAVMs (P = .024, 95% confidence interval, 1.128-5.009). During the 3-month evaluation, complete response was observed in 13 of 36 patients (36.1%), and partial response was observed in 23 of 36 patients (63.9%). The 5-year recurrence-free survival rate for patients who underwent Onyx treatment had improved 58.3% after ethanol embolization (95% confidence interval, 2.853-9.595; P < .0001). CONCLUSIONS Coil-assisted ethanol embolotherapy could treat refractory HNAVMs with Onyx recrudescence effectively.
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Affiliation(s)
- Yuchen Shen
- Vascular Anomaly Center. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Deming Wang
- Vascular Anomaly Center. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingzhe Wen
- Vascular Anomaly Center. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ruoyu Di
- Vascular Anomaly Center. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xindong Fan
- Vascular Anomaly Center. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lixin Su
- Fengcheng Hospital of Feng Xian District, Fengcheng Branch, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xitao Yang
- Vascular Anomaly Center. Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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26
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Mansour MA, Ali H, Ayad AA. Quadriplegia in a Child With Spinal Arteriovenous Metameric Syndrome. Neurology 2023; 101:672-673. [PMID: 37596040 PMCID: PMC10585687 DOI: 10.1212/wnl.0000000000207539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/04/2023] [Indexed: 08/20/2023] Open
Affiliation(s)
- Moustafa A Mansour
- From the Department of Neurology and Neurologic Surgery (M.A.M., A.A.A.), Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Department of Neurology and Neurologic Surgery (M.A.M.), Mayo Clinic, Rochester, MN; Division of Neuro-Intensive Care (M.A.M.), Dar Al-Fouad Medical Corporation; Department of Emergency Medicine and Critical Care (M.A.M., A.A.A.); Department of Pediatrics (H.A.); and Division of Neurology and Neurodevelopmental Disorders (H.A.), Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.
| | - Hassan Ali
- From the Department of Neurology and Neurologic Surgery (M.A.M., A.A.A.), Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Department of Neurology and Neurologic Surgery (M.A.M.), Mayo Clinic, Rochester, MN; Division of Neuro-Intensive Care (M.A.M.), Dar Al-Fouad Medical Corporation; Department of Emergency Medicine and Critical Care (M.A.M., A.A.A.); Department of Pediatrics (H.A.); and Division of Neurology and Neurodevelopmental Disorders (H.A.), Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmad A Ayad
- From the Department of Neurology and Neurologic Surgery (M.A.M., A.A.A.), Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Department of Neurology and Neurologic Surgery (M.A.M.), Mayo Clinic, Rochester, MN; Division of Neuro-Intensive Care (M.A.M.), Dar Al-Fouad Medical Corporation; Department of Emergency Medicine and Critical Care (M.A.M., A.A.A.); Department of Pediatrics (H.A.); and Division of Neurology and Neurodevelopmental Disorders (H.A.), Department of Pediatrics, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
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27
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Mampaey G, Stock E, Kromhout K, Stammeleer L, Roggeman T, Smets P. Pulmonary arteriovenous malformation and a concurrent patent ductus arteriosus in a Doberman. J Vet Cardiol 2023; 49:44-51. [PMID: 37801771 DOI: 10.1016/j.jvc.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 08/11/2023] [Accepted: 08/15/2023] [Indexed: 10/08/2023]
Abstract
A 7-week-old male Doberman presented with tachypnea, dyspnea and a VI/VI, left cranial, continuous heart murmur. Thoracic radiographs revealed severe left-sided cardiomegaly, presence of a rounded soft tissue opacity in the caudodorsal aspect of the thoracic cavity and signs of left-sided congestive heart failure. Clinical signs of heart failure were medically controlled. Echocardiography and computed tomography demonstrated a left-to-right shunting patent ductus arteriosus (PDA) in combination with a right-to-left shunting pulmonary arteriovenous malformation (PAVM) between the right main pulmonary artery and the right caudal pulmonary vein. Arterial blood gasses revealed mild hypoxemia. Transcatheter occlusion of the PDA using an Amplatz Canine Duct Occluder was performed. Four months post-operatively, echocardiography showed normal cardiac size and function with complete PDA closure. Thoracic radiographs revealed absence of the rounded opacity and resolution of cardiomegaly and vascular congestion. The PAVM was no longer visualized on repeated computed tomography and the arterial blood gasses were within normal limits. A PAVM connecting a pulmonary artery to a pulmonary vein has only rarely been reported in dogs. This report describes the presence of a congenital PAVM in combination with a PDA in a dog, which has not been previously reported in veterinary medicine.
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Affiliation(s)
- G Mampaey
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - E Stock
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - K Kromhout
- Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - L Stammeleer
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - T Roggeman
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - P Smets
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Kılıçkıran Avcı B, Soysal AU, Cerme E, Kargın OA, Hatemi Aİ, Ar MC, Öngen Z. Pulmonary Hypertension Due to High-Output Heart Failure: Hereditary Hemorrhagic Telangiectasia. Turk Kardiyol Dern Ars 2023; 51:493-497. [PMID: 37861254 DOI: 10.5543/tkda.2023.13614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023] Open
Abstract
Pulmonary hypertension (PH) is a complex disorder that should be managed with a multidisciplinary approach. Although most of the underlying causes of left heart disease can be easily diagnosed with cardiac imaging, some pathologies might necessitate careful investigation to go beyond the obvious. High-output heart failure (HF) due to arteriovenous malformation (AVMs) is an unnoticeable cause for HF and PH. Patients with hepatic AVMs should always be carefully evaluated with regard to hereditary hemorrhagic telangiectasia (HHT) since they can have multiple signs related to the other systems without any symptoms. In this case report, we discussed a patient who was initially diagnosed as PH associated with HF with preserved ejection fraction but eventually was found to have PH associated with high-output HF due to hereditary hemorrhagic telangiectasia (HHT, or Osler Weber Rendu syndrome) after detailed evaluation.
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Affiliation(s)
- Burçak Kılıçkıran Avcı
- Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Ali Uğur Soysal
- Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Emir Cerme
- Department of Internal Medicine, Division of Gastroenterology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Osman Aykan Kargın
- Department of Radiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Ali İbrahim Hatemi
- Department of Internal Medicine, Division of Gastroenterology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Muhlis Cem Ar
- Department of Internal Medicine, Division of Hematology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
| | - Zeki Öngen
- Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, İstanbul, Türkiye
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Yoshida K, Niimi Y, Kamamoto D, Fukumura M, Imai R, Nagoshi N, Akiyama T. Targeted embolisation for coexisting conus medullaris arteriovenous malformation and cauda equina arteriovenous fistulas with a varix on a shared drainer †. Br J Neurosurg 2023; 37:1200-1205. [PMID: 33034527 DOI: 10.1080/02688697.2020.1830948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The coexistence of vascular malformations in the conus medullaris and cauda equina has been rarely reported, and the complex angioarchitecture in multiple arteriovenous lesions remains poorly understood. CASE DESCRIPTION A 17-year-old woman presented with a sudden-onset, stepwise worsening of weakness and pain in the bilateral legs. Angiography revealed conus medullaris arteriovenous malformation and cauda equina arteriovenous fistulas. One of the drainers was shared between the coexisting lesions and harboured a varix. Targeted embolisation of a fistulous point in the conus lesion was performed with precaution to prevent occluding the common drainage route, which led to symptom improvement with angiographical diminishment of the varix. CONCLUSIONS Recognising that communications between drainers can be observed in multiple spinal arteriovenous lesions is important in facilitating a safe embolisation. Cautious assessment of angiogram with fusion images of cone-beam computed tomography and volumetric T2 magnetic resonance imaging can help in establishing the diagnosis and treatment strategy.
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Affiliation(s)
- Keisuke Yoshida
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasunari Niimi
- Department of Neuroendovascular Therapy, St. Luke's International Hospital, Tokyo, Japan
| | - Dai Kamamoto
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Mariko Fukumura
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Ryotaro Imai
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
| | - Narihito Nagoshi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Takenori Akiyama
- Department of Neurosurgery, Keio University School of Medicine, Tokyo, Japan
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Alzate JD, Mashiach E, Raz E, Shapiro M, Riina H, Kondziolka D. Advances in Radiosurgical Planning: High-Resolution Imaging and Objective Hemodynamic Measurements for Arteriovenous Malformations. World Neurosurg 2023; 178:264-265. [PMID: 37573234 DOI: 10.1016/j.wneu.2023.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023]
Affiliation(s)
- Juan Diego Alzate
- Departments of Neurological Surgery, NYU Langone Health, New York University, New York, New York, USA
| | - Elad Mashiach
- Departments of Neurological Surgery, NYU Langone Health, New York University, New York, New York, USA
| | - Eytan Raz
- Department of Interventional Neuroradiology, NYU Langone Health, New York University, New York, New York, USA
| | - Maksim Shapiro
- Department of Interventional Neuroradiology, NYU Langone Health, New York University, New York, New York, USA
| | - Howard Riina
- Departments of Neurological Surgery, NYU Langone Health, New York University, New York, New York, USA; Department of Interventional Neuroradiology, NYU Langone Health, New York University, New York, New York, USA
| | - Douglas Kondziolka
- Departments of Neurological Surgery, NYU Langone Health, New York University, New York, New York, USA
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Nakajima M, Morishima Y, Mori K, Yoshida K, Kuramoto K, Matsuyama M, Kiwamoto T, Matsuno Y, Hizawa N. Hereditary Hemorrhagic Telangiectasia with Diffuse Bronchopulmonary Arteriovenous Malformations. Am J Respir Crit Care Med 2023; 208:726-727. [PMID: 37315322 DOI: 10.1164/rccm.202301-0062im] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/14/2023] [Indexed: 06/16/2023] Open
Affiliation(s)
| | | | - Kensaku Mori
- Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Wang CL, Chen CW. Surgical intervention of a femoral shaft fracture in a patient with intraosseous arteriovenous malformation: A case report. J Orthop Sci 2023; 28:1202-1205. [PMID: 33640223 DOI: 10.1016/j.jos.2020.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 11/08/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Cheng-Long Wang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, PR China.
| | - Cheng-Wei Chen
- Department of Orthopedic Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, 325000, PR China.
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Panda SK, Nikhila GP, Kavya PS. Propranolol in Congenital Hepatic Arteriovenous Malformation. Indian J Pediatr 2023; 90:952. [PMID: 37264277 DOI: 10.1007/s12098-023-04707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 05/26/2023] [Indexed: 06/03/2023]
Affiliation(s)
- Santosh Kumar Panda
- Department of Pediatrics, Kalinga Institute of Medical Sciences, KIIT DU, Bhubaneswar, Odisha, India.
| | | | - Palnati Sai Kavya
- Department of Pediatrics, Kalinga Institute of Medical Sciences, KIIT DU, Bhubaneswar, Odisha, India
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Tuleja A, Bernhard S, Hamvas G, Andreoti TA, Rössler J, Boon L, Vikkula M, Kammer R, Haupt F, Döring Y, Baumgartner I. Clinical phenotype of adolescent and adult patients with extracranial vascular malformation. J Vasc Surg Venous Lymphat Disord 2023; 11:1034-1044.e3. [PMID: 37030445 DOI: 10.1016/j.jvsv.2023.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 04/10/2023]
Abstract
OBJECTIVE In recent years, genotypic characterization of congenital vascular malformations (CVMs) has gained attention; however, the spectrum of clinical phenotype remains difficult to attribute to a genetic cause and is rarely described in the adult population. The aim of this study is to describe a consecutive series of adolescent and adult patients in a tertiary center, where a multimodal phenotypic approach was used for diagnosis. METHODS We analyzed clinical findings, imaging, and laboratory results at initial presentation, and set a diagnosis according to the International Society for the Study of Vascular Anomalies (ISSVA) classification for all consecutively registered patients older than 14 years of age who were referred to the Center for Vascular Malformations at the University Hospital of Bern between 2008 and 2021. RESULTS A total of 457 patients were included for analysis (mean age, 35 years; females, 56%). Simple CVMs were the most common (n = 361; 79%), followed by CVMs associated with other anomalies (n = 70; 15%), and combined CVMs (n = 26; 6%). Venous malformations (n = 238) were the most common CVMs overall (52%), and the most common simple CVMs (66%). Pain was the most frequently reported symptom in all patients (simple, combined, and vascular malformation with other anomalies). Pain intensity was more pronounced in simple venous and arteriovenous malformations. Clinical problems were related to the type of CVM diagnosed, with bleeding and skin ulceration in arteriovenous malformations, localized intravascular coagulopathy in venous malformations, and infectious complications in lymphatic malformations. Limb length difference occurred more often in patients with CVMs associated with other anomalies as compared with simple or combined CVM (22.9 vs 2.3%; P < .001). Soft tissue overgrowth was seen in one-quarter of all patients independent of the ISSVA group. CONCLUSIONS In our adult and adolescent population with peripheral vascular malformations, simple venous malformations predominated, with pain as the most common clinical symptom. In one-quarter of cases, patients with vascular malformations presented with associated anomalies on tissue growth. The differentiation of clinical presentation with or without accompanying growth abnormalities need to be added to the ISSVA classification. Phenotypic characterization considering vascular and non-vascular features remains the cornerstone of diagnosis in adult as well as pediatric patients.
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Affiliation(s)
- Aleksandra Tuleja
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University, Hospital, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - Sarah Bernhard
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University, Hospital, Bern, Switzerland
| | - Györgyi Hamvas
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University, Hospital, Bern, Switzerland
| | - Themis-Areti Andreoti
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Inselspital - University Hospital of Bern, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Jochen Rössler
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Inselspital - University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Laurence Boon
- Center for Vascular Anomalies, Division of Plastic Surgery, VASCERN VASCA European Reference Centre, Saint Luc University Hospital, Brussels, Belgium
| | - Miikka Vikkula
- Center for Vascular Anomalies, Division of Plastic Surgery, VASCERN VASCA European Reference Centre, Saint Luc University Hospital, Brussels, Belgium; Human Molecular Genetics, de Duve Institute, University of Louvain, Brussels, Belgium
| | - Rafael Kammer
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University, Hospital, Bern, Switzerland
| | - Fabian Haupt
- Department of Radiology, Inselspital, Bern University, Hospital, Bern, Switzerland
| | - Yvonne Döring
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University, Hospital, Bern, Switzerland; Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland; Institute for Cardiovascular Prevention (IPEK), Ludwig-Maximilians-University Munich (LMU), Munich, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Iris Baumgartner
- Division of Angiology, Swiss Cardiovascular Center, Inselspital, Bern University, Hospital, Bern, Switzerland
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Wang X, Zhao Z. Renal arteriovenous malformation causing hematuria: Case report and review of the literature. Medicine (Baltimore) 2023; 102:e34547. [PMID: 37653758 PMCID: PMC10470693 DOI: 10.1097/md.0000000000034547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/12/2023] [Indexed: 09/02/2023] Open
Abstract
RATIONALE Renal arteriovenous malformations are rare vascular morphological anomalies that can be classified as congenital, idiopathic and acquired, of which congenital renal arteriovenous malformations are the most common. This disease is a rare cause of hematuria. In this case report, we report the diagnosis and treatment of a patient with renal arteriovenous malformation. We also review the symptoms, diagnosis and treatment of renal arteriovenous malformations in the published literature. PATIENT CONCERNS A 35-year-old female patient presented to a local hospital with right-sided lumbar abdominal pain with hematuria for 2 days. Physical examination showed percussion pain in the right renal area. Laboratory tests such as routine blood and blood biochemistry did not show any significant abnormalities when the patient entered the hospital. Considering the patient's medical history, a urological computed tomography scan showed blood accumulation in the right renal pelvis, upper middle ureter and bladder. Subsequently, routine blood tests showed that the patient's red blood cells and hemoglobin continued to decrease. An emergency renal arteriogram was performed, which showed a tortuous right upper renal pole branch artery and multiple thickened veins communicating with it. DIAGNOSIS This patient was diagnosed with cirsoid renal arteriovenous malformation. INTERVENTIONS Renal artery embolization was performed immediately after the renal arteriogram was performed on the patient. OUTCOMES On review of the angiogram, the tortuous right upper renal pole branch artery was found to be obstructed, and the thickened vein disappeared, and the renal vein was normally visualized in due course. On the third postoperative day, the patient was free of hematuria. Physical examination showed no percussion pain in the renal area. The patient healed and was discharged. A 1-year follow-up was performed and the patient gave feedback that she no longer had symptoms such as back pain and hematuria in her daily life. LESSONS This case illustrates that early use of vascular interventions is an important method for the diagnosis and treatment of cirsoid renal arteriovenous malformations.
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Affiliation(s)
- Xin Wang
- Clinical Medical College, Jining Medical University, Jining, China
| | - Zhankui Zhao
- Department of Urology, Affiliated Hospital of Jining Medical University, Jining, China
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Alashaikh FM, Alhamadh MS, Alsugair SI, Alkhayal A, Abumelha S, Al Zahrani Y, BinSwilim A. Recurrent Scrotal Arteriovenous Malformation as a Slowly Increasing Left Testicular Swelling: A case report. Sultan Qaboos Univ Med J 2023; 23:397-399. [PMID: 37655073 PMCID: PMC10467540 DOI: 10.18295/squmj.4.2022.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/16/2022] Open
Abstract
Arteriovenous malformations (AVMs) are benign vascular lesions. Although, the majority of AVMs occur in the central nervous system, there are published reports of AVMs involving all systems including the scrotum, kidney, and uterus. We report a 37-year-old male patient who presented to the urology clinic of a tertiary care hospital in Riyadh, Saudi Arabia, in 2021 with recurrent gradual scrotal swelling for four years attributed to scrotal AVM. Embolisation was performed; however, one year later his symptoms reoccurred. As a result, left partial scrotal wall excision was carried out without complications.
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Affiliation(s)
- Faisal M. Alashaikh
- College of Medicine, King Saud ben Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Moustafa S. Alhamadh
- College of Medicine, King Saud ben Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Sulaiman I. Alsugair
- College of Medicine, King Saud ben Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Abduallah Alkhayal
- College of Medicine, King Saud ben Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Saad Abumelha
- College of Medicine, King Saud ben Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Department of Surgery, Division of Urology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - Yousof Al Zahrani
- King Abdullah International Medical Research Center, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
- Department of Medical Imaging, Division of Interventional Radiology, King Abdulaziz Medical City, Ministry of the National Guard-Health Affairs, Riyadh, Saudi Arabia
| | - AbdulRahman BinSwilim
- Department of Medical Imaging, King Khalid University Hospital, Riyadh, Saudi Arabia
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Yang WH, Xiang XJ, Li HL. Sclerotherapy for congenital vascular malformations with mixing foam of polidocanol and liquid of bleomycin. Phlebology 2023; 38:451-457. [PMID: 37318342 DOI: 10.1177/02683555231184772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE To evaluate the efficacy of sclerotherapy for congenital vascular malformation (CVM) using a combination of polidocanol foam and bleomycin liquid. METHODS A retrospective review of a prospectively collected data on patients who had sclerotherapy for CVM from May 2015 to July 2022 was performed. RESULTS A total of 210 patients with a mean age of 24.8 ± 2.0 years were included. Venous malformation (VM) was the most common type of CVM, accounting for 81.9% (172/210) of all patients. At 6 months follow-up, the overall clinical effective rate was 93.3% (196/210), and 50% (105/210) of patients were clinically cured. The clinical effective rates in VM, lymphatic, and arteriovenous malformation group were 94.2%, 100%, and 100%. CONCLUSION Sclerotherapy using a combination of polidocanol foam and bleomycin liquid is an effective and safe treatment for venous and lymphatic malformations. It is a promising treatment option with satisfactory clinical outcome in arteriovenous malformations.
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Affiliation(s)
- Wei-Hong Yang
- Department of Interventional Radiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Xian-Jun Xiang
- Department of Interventional Radiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Hai-Lei Li
- Division of Vascular Surgery, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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Kularatne M, Eyries M, Savale L, Humbert M, Montani D. Isolated Pulmonary Arteriovenous Malformations Associated With BMPR2 Pathogenic Variants. Chest 2023; 164:e23-e26. [PMID: 37094738 DOI: 10.1016/j.chest.2023.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 04/26/2023] Open
Abstract
Heritable pulmonary arterial hypertension (PAH) is an uncommon cause of PAH and is associated most frequently with pathogenic variants of BMPR2. Prior studies have described abnormalities in pulmonary arterial, venous, and bronchial artery vessels associated with these pathogenic variants. In this series, we describe two patients who demonstrated pulmonary arteriovenous malformations (AVMs) and incidentally were identified by a next generation sequencing gene panel to carry variants of BMPR2 in the absence of PAH. Although pulmonary AVMs commonly are associated with hereditary hemorrhagic telangiectasia and rarely are seen in heritable PAH, evidence is increasing that abnormalities in the BMP9 pathway are found in both of these conditions. Through these cases and the current understanding of the BMP9 pathway, we propose that BMPR2 variants place patients at increased risk of pulmonary AVMs and may warrant screening.
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Affiliation(s)
- Mithum Kularatne
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France; INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis Robinson, France; University of Calgary, Calgary, AB, Canada
| | - Mélanie Eyries
- AP-HP, Département de Génétique, Hôpital Pitié-Salpêtrière UMR_S 1166 Sorbonne Université, Paris, France
| | - Laurent Savale
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France; INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Marc Humbert
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France; INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - David Montani
- Faculty of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France; AP-HP, Department of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, DMU 5 Thorinno, Le Kremlin-Bicêtre, France; INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis Robinson, France.
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Nusca A, Viscusi MM, Ussia GP. Double anterograde/retrograde approach for embolization of pulmonary arteriovenous malformation presenting with acute respiratory failure. Eur Heart J 2023; 44:2348. [PMID: 36806935 DOI: 10.1093/eurheartj/ehad071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Affiliation(s)
- Annunziata Nusca
- Department of Cardiovascular Sciences, Campus Bio-Medico University, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Michele Mattia Viscusi
- Department of Cardiovascular Sciences, Campus Bio-Medico University, Via Alvaro del Portillo 200, Rome 00128, Italy
| | - Gian Paolo Ussia
- Department of Cardiovascular Sciences, Campus Bio-Medico University, Via Alvaro del Portillo 200, Rome 00128, Italy
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Ben Abdallah I, Cerceau P. Challenging Resection of a Massive Ulcerated Arteriovenous Malformation Within the Latissimus Dorsi Muscle. Eur J Vasc Endovasc Surg 2023; 66:118. [PMID: 37150476 DOI: 10.1016/j.ejvs.2023.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/22/2023] [Accepted: 05/03/2023] [Indexed: 05/09/2023]
Affiliation(s)
- Iannis Ben Abdallah
- Department of Vascular and Thoracic Surgery, Hôpital Bichat and Reference Centre for Vascular Anomalies, Hôpital Lariboisière, Université Paris Cité, Paris, France.
| | - Pierre Cerceau
- Department of Vascular and Thoracic Surgery, Hôpital Bichat and Reference Centre for Vascular Anomalies, Hôpital Lariboisière, Université Paris Cité, Paris, France
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Su L, Yang X, Wang Z, Wen M, Fan X, Wang D. Eradication of the nidus in arteriovenous malformations with a dominant outflow vein in the lower extremities using coils and absolute ethanol. J Vasc Surg Venous Lymphat Disord 2023; 11:809-815. [PMID: 37076100 DOI: 10.1016/j.jvsv.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/14/2022] [Accepted: 10/16/2022] [Indexed: 04/21/2023]
Abstract
OBJECTIVE In the present study, we summarize our experience in locating the nidus of arteriovenous malformations (AVMs) with a dominant outflow vein (DOV) in the lower extremities and eradicating the nidus with ethanol and coils. METHODS Twelve patients with lower extremity AVMs who underwent ethanol embolization combined with DOV occlusion from January 2017 to May 2018 were enrolled in the present study. Selective angiography was used to locate the nidus of the AVMs, which was eradicated using ethanol and coils via the direct puncture pathway. All treated patients underwent postoperative follow-up (mean, 25.5 months; range, 14-37 months). RESULTS The 12 patients underwent a total of 29 procedures (mean, 2.4; range, 1-4) with 27 detachable coils and 169 Nester coils (Cook Medical Inc, Bloomington, IN). Of the 12 patients, 7 (58.3%) had a complete response and 5 (41.7%) a partial response. Three patients (25%) had minor complications such as blister and superficial skin ulcers during follow-up. However, they recovered spontaneously and completely. No major complications were recorded. CONCLUSIONS Ethanol embolization combined with coil-assisted DOV occlusion has the potential to eradicate the nidus of lower extremity AVMs with acceptable complication rates.
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Affiliation(s)
- Lixin Su
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xitao Yang
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhenfeng Wang
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Mingzhe Wen
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xindong Fan
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Deming Wang
- Department of Interventional Therapy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Xie Z, Wang Y, Chen R. Persistent cornual pregnancy mimicking uterine arteriovenous malformation: a case report. BMC Womens Health 2023; 23:314. [PMID: 37328873 PMCID: PMC10276523 DOI: 10.1186/s12905-023-02450-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/24/2023] [Indexed: 06/18/2023] Open
Abstract
BACKGROUND Uterine arteriovenous malformation(AVM) refers to the abnormal direct traffic between uterine arteries and veins, which can be characterized by the imaging examination, showing increased uterine vascularity and arteriovenous shunting. However, similar imaging manifestations can also be seen in a variety of conditions including retained production of conception, gestational trophoblastic disease, placental polyp, and vascular neoplasm. CASE PRESENTATION Here we present a case of a 42-year-old woman who was suspected of suffering uterine AVM indicated by Doppler sonography and magnetic resonance imaging but was finally diagnosed with a persistent ectopic pregnancy located on the right uterine corner by pathology after laparoscopy. She recovered well after surgery. CONCLUSION Uterine AVM is a rare and serious condition. In general, it presents special radiological manifestations. However, when complicated with other diseases it can also be distorting. Standardized diagnosis and management are important.
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Affiliation(s)
- Zhuolin Xie
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Yang Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
| | - Rong Chen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, National Clinical Research Center for Obstetric & Gynecologic Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China
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Sato H, Lepić M, Suzuki K, Tabata S, Tamada K, Kume H, Shiwaku H, Ooigawa H, Kurita H. Reversible splenial lesion after surgery for distant arteriovenous malformation: a case report. Acta Neurochir (Wien) 2023; 165:1603-1607. [PMID: 37055680 PMCID: PMC10101539 DOI: 10.1007/s00701-023-05573-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/29/2023] [Indexed: 04/15/2023]
Abstract
Isolated lesions of the corpus callosum are rare and may represent permanent but also transient responses to various pathology termed "reversible splenial lesion syndrome" (RESLES) when in light of relevant clinical presentation. We present the first case of the RESLES after elective surgery for distant arteriovenous malformation (AVM), followed by a slight speech disturbance and MRI verified small, oval, well-circumscribed area of apparent cytotoxic edema in the center of the corpus callosum splenium, which completely resolved within 15 days. Surgery for AVM is followed by the complex adaptation to a new vascular pattern, RESLES might develop, and should be suspected.
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Affiliation(s)
- Hiroki Sato
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan.
| | - Milan Lepić
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Kaima Suzuki
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Shinya Tabata
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Keita Tamada
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Haruka Kume
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Hiroya Shiwaku
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Hidetoshi Ooigawa
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka-shi, Saitama-ken, Japan
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Li X, Fan XD, Wang DM, Yang XT, Su LX. [Clinical analysis of interventional embolization for 9 cases with frontal arteriovenous malformation]. Shanghai Kou Qiang Yi Xue 2023; 32:332-336. [PMID: 37803994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
PURPOSE To investigate the efficacy and safety of interventional embolization in the treatment of frontal arteriovenous malformation (AVM). METHODS A retrospective study was used to analyze 9 patients with frontal AVM who were treated in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine. The patients were treated with interventional embolization under the guidance of DSA. The scope of lesions was observed through DSA, and the injection dose of sclerosing agent was predicted so that the drug could be injected into the lesion cavity. The efficacy, adverse reactions and complications of all patients were observed and analyzed. RESULTS Among the 9 patients, there were 7 males(77.8%) and 2 females(22.2%), aged from 1.5-20 years old. Local swelling or mass was the main reported symptom(66.7%). The blood supply arteries of the cases involved in this study included superficial temporal artery and ophthalmic artery. All patients received interventional embolization treatment under general anesthesia, a total of 19 times (each patient received 1-6 times, average 2.1 times/person), and the average single dose of absolute ethanol was 9.0 mL. A total of 80 coils (4.2 coils/time on average) were used for 5 times (80 coils/19 times) with absolute ethanol embolization. In addition, bleomycin was used 3 times, pingyangmycin was used 2 times, and 3% polydocanol was used 1 time to assist embolization. Among the 9 cases included in this study, 4 cases were cured, 3 cases were basically cured, 2 cases were improved, and the effective rate of treatment was 100%. No local or systemic complications were reported in all patients. CONCLUSIONS In the treatment of frontal arteriovenous malformation, correct diagnosis according to clinical and imaging manifestations, and interventional embolization with anhydrous ethanol according to DSA angiography results can reduce trauma, improve symptoms, control lesions, and obtain relatively satisfactory treatment results. This scheme is safe and effective.
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Affiliation(s)
- Xiao Li
- The 2nd Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology. Shanghai 200011, China. E-mail:
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Ishida K, Ako J, Tojo T. Concomitant Klippel-Trenaunay-Weber syndrome with pelvic arteriovenous malformation and May-Thurner syndrome: A rare presentation. Am J Med Sci 2023; 365:e57-e58. [PMID: 36272519 DOI: 10.1016/j.amjms.2022.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/16/2022] [Accepted: 10/14/2022] [Indexed: 12/25/2022]
Affiliation(s)
- Kohki Ishida
- Department of Cardiovascular medicine, Kitasato University Kitasato Institute Hospital, Minato-ku, Japan.
| | - Junya Ako
- Department of Cardiovascular medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Taiki Tojo
- Department of Cardiovascular medicine, Kitasato University Kitasato Institute Hospital, Minato-ku, Japan
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Kabiri D, Gavra H, Keidar Haran T, Goldschmidt N, Elazary R, Mei-Zahav M. Pregnancy-associated ruptured splenic arteriovenous malformation: A rare but fatal complication in hereditary hemorrhagic telangiectasia. Eur J Obstet Gynecol Reprod Biol 2023; 283:158-159. [PMID: 36801085 DOI: 10.1016/j.ejogrb.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 02/10/2023] [Indexed: 02/13/2023]
Affiliation(s)
- Doron Kabiri
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
| | - Hadar Gavra
- Department of Obstetrics and Gynecology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Tal Keidar Haran
- Department of Pathology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Neta Goldschmidt
- Department of Hematology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Ram Elazary
- Department of Surgery, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel
| | - Meir Mei-Zahav
- Pulmonary Institute, Schneider Children's Medical Center of Israel, Petach Tikva, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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Bian W, Yuan J, Yao Y. Hemorrhage and necrosis of the liver caused by hepatic arteriovenous malformations in a fetus: A case report. Medicine (Baltimore) 2023; 102:e33380. [PMID: 36961151 PMCID: PMC10036009 DOI: 10.1097/md.0000000000033380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/08/2023] [Indexed: 03/25/2023] Open
Abstract
RATIONALE Hepatic arteriovenous malformations (HAVMs) are a rare disorder reported in association with hereditary hemorrhagic telangiectasia (HHT), known as Rendu-Osler-Weber syndrome. HAVMs are usually detected in adulthood. PATIENT CONCERNS A 29-year-old pregnant woman underwent a routine prenatal examination at 37 weeks of pregnancy. DIAGNOSIS AND INTERVENTIONS There were fetal liver anomalies detected by prenatal ultrasonography and were managed. Furthermore, a hepatic mass was detected and was subsequently analyzed by fetal magnetic resonance imaging. There were no typical imaging findings in this case which was once misdiagnosed as a hepatoblastoma. OUTCOMES Considering the massive hepatic lesion, labor induction was performed on a pregnant woman to avoid adverse maternal and fetal outcomes. Histopathological examination confirmed the diagnosis of HAVMs. Lesions detected by imaging were determined to be hemorrhagic and necrotic. LESSONS Prenatal hepatic hemorrhage and necrosis due to an arteriovenous malformation are rare. The authors describe their observations and results.
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Affiliation(s)
- Wei Bian
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
| | - Jun Yuan
- Department of Pathology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
| | - Yuan Yao
- Department of Radiology, Jiaxing Maternity and Child Health Care Hospital, Jiaxing, China
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Chang CT, Lim WX, Liu TT, Lin YM, Chang CD. Inferior mesenteric artery arteriovenous malformation, a rare cause of ischemic colitis: A case report. Medicine (Baltimore) 2023; 102:e33413. [PMID: 36961132 PMCID: PMC10036045 DOI: 10.1097/md.0000000000033413] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/10/2023] [Indexed: 03/25/2023] Open
Abstract
RATIONALE An arteriovenous malformation (AVM) is an abnormal tangle of blood vessels that connects the arteries and the veins. Because normal capillary bed is partially or completely absented in the AVM, the blood passes quickly from the arteries to the veins, which disrupts normal blood flow and oxygen supply to the surrounding tissues. This is called "steal phenomenon," and in the inferior mesenteric artery (IMA) territory, this may lead to abdominal pain, gastrointestinal bleeding, portal hypertension, and even ischemic colitis. PATIENT CONCERNS A 67-year-old man presented to our emergency department because of left side abdominal pain. DIAGNOSES The abdominal computed tomography with contrast enhancement revealed a cluster of abnormal vascular lesions abutting the IMA with early opacification of the left colonic marginal vein. In addition, poor enhancement of segmental colonic wall was found from proximal descending colon to middle rectum. The diagnosis of AVM of the IMA and ischemic colitis was made. INTERVENTIONS The patient underwent left hemicolectomy as well as the AVM resection. OUTCOMES He was discharged uneventfully after the surgery without complications. LESSONS IMA AVM carries the risk of ischemic colitis. computed tomography scan is helpful not only to the diagnosis of AVMs but also to exclude other lesions as well. Treatment options include endovascular embolization, surgical intervention, and a combination of both. Due to the complexity of this disease, treatment requires a case-specific multidisciplinary approach and a coordination of medical, radiological, and surgical staffs.
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Affiliation(s)
- Ching-Tang Chang
- Department of Emergency, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - Wei-Xiong Lim
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ting-Ting Liu
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yueh-Ming Lin
- Department of Surgery, Division of Colorectal Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ching-Di Chang
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Beji H, Kallel Y, Mroua B, Zribi S, Bouassida M, Touinsi H. Cystic mass with arteriovenous malformations of the lesser omentum. ANZ J Surg 2023; 93:722-723. [PMID: 35876717 DOI: 10.1111/ans.17926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Hazem Beji
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Yassine Kallel
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Bassem Mroua
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Slim Zribi
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Mahdi Bouassida
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
| | - Hassen Touinsi
- Department of general surgery Hospital Mohamed Taher Maamouri Nabeul, University of Tunis El Manar, Tunis, Tunisia
- Department of General Surgery, Hospital Mohamed Taher Maamouri Nabeul, Tunis, Tunisia
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50
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El-Ghandour NMF. Commentary: Microsurgical Resection of a T8 Spinal Cord Arteriovenous Malformation: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown) 2023; 24:e205-e206. [PMID: 36562626 DOI: 10.1227/ons.0000000000000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/01/2022] [Indexed: 12/24/2022] Open
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