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Haitham Odat, Khaled Alawneh, Mohannad Al-Qudah
Jugular paragangliomas are slow growing highly vascular tumors arising from jugular paraganglia. The gold standard of treatment is complete surgical resection. Pre-operative embolization of these highly vascular tumors is essential to reduce intra-operative bleeding, allow safe dissection, and decrease operative time and post-operative complications. Onyx (ethylene-vinyl alcohol copolymer) has been widely used as permanent occluding material for vascular tumors of skull base because of its unique physical properties...
March 7, 2018: Journal of Clinical Medicine
A Coelho, P Brandão, M Lobo, I Lojo, A Canedo
INTRODUCTION: Major pelvic Ilio-Iliac arteriovenous fistula (AVF) is an exceedingly rare diagnosis with only a few described cases in the literature, most of them related to congenital defects or trauma. In this case report, we aim to present a case of an ilio-iliac AVF with an atypical clinical presentation. CASE REPORT: The patient is a 77-year-old women, with a relevant medical history of a temporally remote hysterectomy. She developed an exuberant unilateral right leg oedema and was diagnosed with a femoro-iliac deep vein thrombosis (DVT) and started on anticoagulation and daily use of elastic compression stockings...
March 5, 2018: Annals of Vascular Surgery
Gulraiz Chaudry, Anna P Lillis, Raja Shaikh, Horacio M Padua, Rush H Chewning, Ahmad I Alomari
PURPOSE: To characterize anatomy of congenital arterioportal fistulas (CAPF) and correlate this with technique and outcomes of transcatheter embolization (TCE). MATERIALS AND METHODS: Retrospective review was conducted of children with CAPF that underwent TCE in a 10-year period. Medical records, imaging and procedure details were reviewed. TCE was performed via transarterial (n = 5), portal (n = 5) or patent ductus venosus (n = 1) approach. Embolic agents used were coils (n = 10), Onyx (n = 1) and Amplatzer septal occluder (n = 1)...
March 6, 2018: Cardiovascular and Interventional Radiology
Akiyo Sadato, Motoharu Hayakawa, Kazuhide Adachi, Yoko Kato, Yuichi Hirose
When using detachable coils for cerebral aneurysm embolization, it is necessary to place a microcatheter with radiopaque markers at 2 sites (tip and 3 cm proximal from the tip) in most cases. Detachable coils that can be positioned independently from the proximal marker may facilitate new applications utilizing their characteristics. Herein, we report 2 cases that were treated with new applications. Detachable coils that function to electrically detect the moment they come out of the microcatheter were used...
January 2018: Asian Journal of Neurosurgery
Saum Rahimi, Naiem Nassiri, Lauren Huntress, Dustin Crystal, Jones Thomas, Randy Shafritz
OBJECTIVES: Multiple endovascular techniques have been described for the treatment of persistent type II endoleaks (pT2ELs) causing aneurysm sac growth following endovascular aneurysm repair (EVAR). In the event of a failed endovascular procedure and a pT2EL, a consensus regarding further treatment is lacking, and the literature suggests repeated endovascular attempts are rarely successful. Herein, we propose an algorithm for definitive management of pT2ELs with persistent sac growth following EVAR...
January 1, 2018: Vascular and Endovascular Surgery
Timothy R Miller, Luciano Giacon, Matthew J Kole, Rong Chen, Gaurav Jindal, Dheeraj Gandhi
Purpose The Apollo Onyx Delivery Microcatheter (Ev3, Irvine, CA) is a detachable-tip microcatheter that was developed to reduce the risk of microcatheter entrapment during ethylene-vinyl alcohol copolymer (Onyx) embolizations. We report our experience with the microcatheter in a variety of neurointerventional procedures. Methods We retrospectively reviewed all Onyx embolizations performed in the head, neck, and spine using the Apollo Onyx Delivery Microcatheter from its introduction at our institution in July 2014 to August 2016...
January 1, 2018: Interventional Neuroradiology
Jesse X Yang, Robert W Yeh
Drug-eluting stents revolutionized the treatment of coronary artery disease with vastly improved outcomes compared with bare metal stents. As stent technology has evolved, a wide variety of antiproliferative drugs have been developed to prevent stent restenosis and stent thrombosis. The Resolute stent system (Medtronic, CA, USA) elutes zotarolimus from a multipolymer blend to prevent early and late stent-related complications. The Resolute stents have evolved from the initial Resolute stent, to the Resolute Integrity™ and most recently, the Resolute Onyx™...
February 16, 2018: Future Cardiology
H G Kortman, I Boukrab, G Bloemsma, J P Peluso, M Sluzewski, B van der Pol, G N Beute, C B Majoie, W J van Rooij
Objective: Tentorial dural arteriovenous fistulas usually drain into cortical veins and often present with hemorrhage. Treatment goal is occlusion of the draining vein, either by surgery or endovascular techniques. We present the multimodality treatment results of 12 patients with tentorial dural arteriovenous fistulas. Materials and Methods: Between January 2007 and January 2017, 12 consecutive patients with tentorial dural arteriovenous fistulas were treated. There were 11 men and 1 woman with a mean age of 62 years (range 44-85)...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Daniel Mantilla, Marine Le Corre, Federico Cagnazzo, Gregory Gascou, Omer Eker, Paolo Machi, Carlos Riquelme, Cyril Dargazanli, Vincent Costalat, Alain Bonafe, Pierre-Henri Lefevre
BACKGROUND AND PURPOSE: Transarterial Onyx embolization is an effective treatment for patients with intracranial dural arteriovenous fistula (DAVF). A study was performed to determine whether the clinical and radiological outcomes after transarterial Onyx treatment were affected by the type of cortical venous drainage (direct vs indirect) of high-grade DAVF. MATERIALS AND METHODS: Between May 2006 and December 2014, demographic data, clinical presentation, angiographic characteristics, and treatment-related outcomes were collected for 54 patients divided into two groups (intracranial DAVF with direct and indirect cortical venous drainage)...
January 30, 2018: Journal of Neurointerventional Surgery
Hazem Mashaly, Zoe Zhang, Andrew Shaw, Patrick Youssef, Ehud Mendel
BACKGROUND AND IMPORTANCE: Hemangiopericytoma is a rare vascular tumor with central nervous system involvement representing only 1% of central nervous system tumors. They rarely affect the vertebral column. Complete surgical resection is the treatment of choice for hemangiopericytoma given their high rates of local recurrence. However, the high vascularity of such tumors with the risk of massive bleeding during surgery represents a significant challenge to surgeons. Therefore, preoperative endovascular embolization via the transarterial route has been advocated...
February 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
Udi Sadeh-Gonike, Nicolas Magand, Xavier Armoiry, Roberto Riva, Paul Emile Labeyrie, Bernadette Lamy, Anne-Claire Lukaszewicz, Jean-Jacques Lehot, Francis Turjman, Benjamin Gory
BACKGROUND: Onyx is important embolic material in the endovascular treatment of intracranial dural arteriovenous fistula (DAVF). However, its impact on DAVF occlusion rates, morbidity, mortality, and complication rates is not fully examined. OBJECTIVE: To improve understanding of safety and effectiveness profiles associated with transarterial endovascular treatment using Onyx for intracranial DAVF. METHODS: We analyzed data from our prospective clinical registry and conducted a systematic review of all previous transarterial embolization studies using Onyx published between January 2005 and December 2015 in MEDLINE and EMBASE...
June 17, 2017: Neurosurgery
Stanimir S Sirakov, Borislav D Kitov, Kristina S Sirakova, Ivo I Kehayov
We describe the case of an 83-year-old woman with left-sided ophthalmoplegia. She had no family history of connective tissue disease. The computed tomography study found a dilated left cavernous sinus. The conventional cerebral panangiography confirmed the diagnosis - a direct carotid-cavernous fistula (CCF), with no evidence of ruptured aneurysm. The woman underwent endovascular treatment with coiling of the cavernous sinus in combination with application of the Onyx embolic agent in the fistula. During the first 48 hours after the embolization the local pain, exophthalmos and conjunctival injection of the left eye were significantly ameliorated...
December 20, 2017: Folia Medica
Beverly H K Po, Jill M Y Chiu
Polybrominated diphenyl ethers have become ubiquitous in the environment and elevated concentrations have often been found in marine organisms. Using the gastropod Crepidula onyx as a study model, this multigenerational study sets out to test the hypotheses that 1) parental dietary exposure to environmentally realistic levels of 2,2',4,4'-tetrabrominated diphenyl ether (BDE-47) would lead to transgenerational impairments on fitness traits of marine invertebrates, and 2) the organisms might develop adaptation/acclimation after exposure for one or more generations...
January 12, 2018: Environmental Pollution
E Giordan, C Bortolotti, G Lanzino, W Brinjikji
BACKGROUND AND PURPOSE: Neural tube defects, such as tethered cord, intradural lipoma, or myelomeningocele may coexist with spinal vascular malformations. The coexistence of these 2 rare entities is suggestive of a causal relationship between them, which may lead to further understanding of their pathogenesis. We present a series of 6 patients with epidural spinal arteriovenous fistulas associated with neural tube defects. MATERIALS AND METHODS: We retrieved cases of spinal vascular malformations associated with neural tube defects seen at our institution...
December 28, 2017: AJNR. American Journal of Neuroradiology
Nicolas K Khattar, Andrew C White, Enzo M Fortuny, Rob T Hruska, Robert F James
Traumatic pseudoaneurysms of the middle meningeal artery (MMA) represent less than 1% of all intracranial aneurysms, and occur mostly in association with temporal bone fractures following head trauma. Given the unknown natural history, it is unclear whether they should be treated. We present two cases of MMA pseudoaneurysms discovered during trauma workups. The first patient is a 44-year-old male with severe traumatic brain injury (TBI) following a motor vehicle accident. The patient was found to have two right-sided middle meningeal artery pseudoaneurysms that were treated successfully with Onyx® (Medtronic, Minneapolis, MN) embolization...
October 23, 2017: Curēus
Pan Li, Xudong Xu, Zheng Zhang, Feiyu Wang, Zhongkai Wang, Feng Chen, Bili Zhang, Yongwen Qin, Shaoping Chen, Xianxian Zhao
AIMS: To evaluate the safety and efficacy of combined of endovascular coiling as well as Onyx embolization in patients with coronary artery fistula (CAF). METHODS AND RESULTS: Between September 2014 and September 2016, 26 patients with CAFs were enrolled in our study for attempted combined therapy using coil and Onyx. The mean age of patients was 64.0±9.5 years (range, 44-78 years). CAFs were large in 10 and medium in 16 patients. The mean number of coils used was 3...
December 26, 2017: EuroIntervention
Leonardo Renieri, Caterina Michelozzi, Waleed Brinjikji, Jean Darcout, Adrien Guenego, Ivan Vukasinovic, Philippe Tall, Fabrice Bonneville, Anne-Christine Januel, Christophe Cognard
BACKGROUND AND PURPOSE: Type I and IIa dural arteriovenous fistulas (DAVFs) have a low hemorrhagic risk, but are often the cause of debilitating tinnitus that requires treatment. While Onyx® and PHIL™ (Precipitating hydrophobic injectable liquid) transarterial embolization represent the first endovascular option, there are occasional cases where performing angioplasty and stenting of the affected sinus may lead to satisfactory results. MATERIAL AND METHODS: We retrospectively analyzed four consecutive cases of patients with DAVF-induced pulsatile tinnitus secondary to type I and II DAVFs who were treated with angioplasty and stenting of the sinus only...
December 14, 2017: Clinical Neuroradiology
Yasutaka Baba, Michiyo Higashi, Kazuo Awai
Transcatheter arterial or venous embolization has been widely used to address solid tumors by occluding the tumor-feeding vessels. It is also performed to treat portosystemic shunts and to stop bleeding by repair of the site of trauma. Commonly used embolic materials are gelatin sponges, coils, beads, and liquid agents such as absolute ethanol, histoacyryl, and onyx. In the field of interventional radiology, embolotherapy is performed routinely. Liquid embolization agents have different characteristics. Their coagulation time, the inflammatory reaction of the vascular wall or surrounding tissue, and their adhesion to the vascular wall vary...
February 2018: Minimally Invasive Therapy & Allied Technologies: MITAT
Serkan Asil, Barış Kaya, Uğur Canpolat, Hikmet Yorgun, Levent Şahiner, Cem Çöteli, Anıl Arat, Kudret Aytemir
AIMS: Percutaneous septal reduction therapy by either alcohol or nonalcohol agents is an alternative approach to surgery in drug-refractory symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). Nonalcohol agents have some advantages and disadvantages over alcohol during the procedure. Nowadays, a novel non-alcohol agent, named as Ethylene-vinyl alcohol (EVOH) copolymer (Onyx® and Squid® ), is used during septal ablation. Thus, in this study, we aimed to evaluate both acute and long-term efficacy and safety profile of EVOH during septal ablation in HOCM...
December 5, 2017: Catheterization and Cardiovascular Interventions
Luana Antunes Maranha Gatto, Fernando Saurin, Gelson Luis Koppe, Zeferino Demartini
Background: Dural arteriovenous fistulas (DAVF) are unusual intracranial vascular malformations consisting of anomalous connections between meningeal arteries and dural sinuses or the veins that pass through them. They have variable clinical presentation and prognosis, which depend on their location and venous hemodynamics. Treatment is based on the closure of the abnormal connections, which is usually conducted via arterial and/or transvenous endovascular techniques. Case Description: We present a male patient who complained of headaches and left-sided pulsatile tinnitus due to DAVF from the external carotid artery branches draining directly into the ipsilateral sigmoid sinus...
2017: Surgical Neurology International
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