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https://www.readbyqxmd.com/read/29352057/feasibility-complications-morbidity-and-mortality-results-at-6-months-for-aneurysm-treatment-with-the-flow-re-direction-endoluminal-device-report-of-safe-study
#1
Laurent Pierot, Laurent Spelle, Jérôme Berge, Anne-Christine Januel, Denis Herbreteau, Mohamed Aggour, Michel Piotin, Alessandra Biondi, Xavier Barreau, Charbel Mounayer, Chrisanthi Papagiannaki, Jean-Paul Lejeune, Jean-Yves Gauvrit, Vincent Costalat
BACKGROUND AND PURPOSE: Flow diverters are increasingly used for the treatment of intracranial aneurysms. Evaluation of the first devices available for clinical use showed high efficacy of this treatment although safety results were worse compared with coiling or balloon-assisted coiling. The Safety and Efficacy Analysis of FRED Embolic Device in Aneurysm Treatment (SAFE) trial is a single-arm, multicenter, prospective study conducted to precisely analyze the safety and efficacy of the FRED and FRED Jr devices...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29350092/focus-on-the-target-angiographic-features-of-the-fistulous-point-and-prognosis-of-transvenous-embolization-of-cavernous-sinus-dural-arteriovenous-fistula
#2
Hui Guo, QianKun Yin, Peng Liu, Ning Guan, Xiaochuan Huo, Youxiang Li
Background and purpose Transvenous embolization (TVE) is widely utilized as an effective and safe treatment option for cavernous sinus dural arteriovenous fistula (CS-dAVF); however, detecting the exact location of the fistula is challenging. The present study identified the angiographic features of the fistulous point and evaluated the match with the microcatheter tip and fistulous point. Materials and methods An analysis cohort of 45 consecutive patients with CS-dAVF treated by TVE was analyzed retrospectively...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29343147/estimation-of-intra-arterial-chemotherapy-distribution-to-the-retina-in-pediatric-retinoblastoma-patients-using-quantitative-digital-subtraction-angiography
#3
Sravani Kondapavulur, Daniel L Cooke, Andrew Kao, Matthew R Amans, Matthew Alexander, Robert Darflinger, Christopher F Dowd, Randall T Higashida, Bertil Damato, Van V Halbach, Katherine K Matthay, Steven W Hetts
Background and purpose The purpose of this article is to estimate the distribution of superselective intra-arterial chemotherapy (IAC) delivery to ocular target tissue using quantitative digital subtraction angiography (qDSA). Materials and methods From March 2010 to January 2016, 50 ophthalmic artery contrast DSAs obtained immediately prior to IAC infusions in 22 patients were analyzed. This study was conducted under a retrospective review IRB (no. 10-01862). Parametric color-coded DSAs (iFlow, Siemens Medical) were post-processed (MATLAB, The Mathworks Inc...
January 1, 2018: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29341947/spontaneous-direct-carotid-cavernous-fistula-in-an-elderly-patient
#4
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
https://www.readbyqxmd.com/read/29326418/a-case-of-right-sided-direct-carotid-cavernous-fistula-a-diagnostic-challenge
#5
Htun Latt, Kyaw Kyaw, Htwe Htwe Yin, Deepak Kapoor, Sammy San Myint Aung, Raheel Islam
BACKGROUND Carotid cavernous fistulas (CCFs) are rare potentially sight-threatening abnormal connections between carotid artery and cavernous sinus. CASE REPORT We report a case of CCF in an 83-year-old female, who presented with swollen and painful right eye. The patient was initially treated with empiric antibiotics for suspected peri-orbital cellulitis, as noted clinically and in computed tomography (CT) orbits. However, lack of clinical improvement, physical finding of orbital bruit/thrill, and enlarged superior ophthalmic vein in magnetic resonance (MR) orbits suggest alternate diagnoses...
January 12, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29288968/value-of-external-carotid-artery-resistive-index-for-diagnosis-of-cavernous-sinus-dural-arteriovenous-fistula-and-determination-of-malignant-type
#6
Chai Kobkitsuksakul, Wasawat Soratcha, Ekachat Chanthanaphak
PURPOSE: Cavernous sinus dural arteriovenous fistula (CSDAVF) causes hemodynamic disturbance in the arteries, which is detected by carotid Doppler sonography (CDS). The objective of the study was designed for validation of CDS in the diagnosis of CSDAVF. MATERIAL AND METHODS: 42 CSDAVF patients confirmed by angiography were enrolled. All patients were performed CDS before angiography. Evaluations of CDS parameters were compared with control subjects. RESULTS: The ECA resistive index (RI) shows the best performance...
November 16, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29260105/invasive-streptococcus-viridans-sphenoethmoiditis-leading-to-an-orbital-apex-syndrome
#7
Lance Bodily, Jenny Yu, Dante Sorrentino, Barton Branstetter
Purpose: Orbital apex syndrome due to spread of infectious sinusitis is a serious disease, often with an insidious presentation with few ophthalmic signs and symptoms. Failure to recognize and treat infectious orbital apex syndrome early portends a grave prognosis, including profound, permanent visual loss and potentially death. Herein we describe a representative case and discuss the relevant aspects of prompt diagnosis and treatment. Observations: An unusual case of infectious orbital apex syndrome due to contiguous spread of Streptococcus viridans sphenoethmoiditis in a hospitalized, immunosuppressed patient with acute myelogenous leukemia is presented...
December 2017: American Journal of Ophthalmology Case Reports
https://www.readbyqxmd.com/read/29251712/prediction-of-traumatic-carotid-cavernous-sinus-fistula-via-non-contrast-ct-by-fracture-pattern-and-abnormality-of-venous-system
#8
Shih-Hsuan Mao, Tzu-Chin Lin, Chih-Hao Chen, Pang-Yun Chou, Shang-Yu Wang, Yon-Cheong Wong, Chien-Tzung Chen
BACKGROUND: Traumatic carotid-cavernous sinus fistula (tCCF) is infrequent but with high morbidity if delayed diagnosed or managed. Due to the lack of screening criteria and requirement of advanced and invasive radiological examinations, diagnosis is often delayed or underdiagnosed. METHODS: A matched case-control study with univariate and multivariate analysis was conducted to predict tCCFs. Forty-six patients diagnosed with tCCFs were included and matched with 138 patients of craniofacial trauma without tCCF as control at a ratio of 1:3...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29245336/amelioration-of-acute-orbital-compartment-syndrome-following-transvenous-embolization-for-an-indirect-carotid-cavernous-fistula-a-case-report
#9
Yun-Hsiu Hsieh, Tzu-Heng Weng, Ming-Cheng Tai, Ke-Hung Chien
RATIONALE: Orbital compartment syndrome (OCS) is a rare occurrence after transvenous embolization of indirect carotid-cavernous fistula (CCF). A lateral canthotomy and cantholysis are the most commonly performed surgical interventions. In our case, as the acute OCS occurred immediately after an uneventful transvenous embolization, an orbital floor orbitectomy was performed. PATIENT CONCERNS: Here, we present a rare case of a 59-year-old patient who required a transvenous embolization of an indirect CCF and subsequently immediately developed an acute OCS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29231794/intracranial-contrast-transit-times-on-digital-subtraction-angiography-decrease-more-in-patients-with-delayed-intraparenchymal-hemorrhage-after-pipeline
#10
Denise Brunozzi, Sophia F Shakur, Fady T Charbel, Ali Alaraj
Background Pipeline embolization devices (PEDs) are used for endovascular treatment of cerebral aneurysms but can be associated with delayed ipsilateral intraparenchymal hemorrhage (DIPH). Changes in intracranial hemodynamics after PED are poorly understood. Objective Here, we assess hemodynamic changes after PED in patients and compare these changes in patients with and without DIPH (DIPH+ and DIPH-). Methods Records of patients with distal internal carotid artery (ICA) aneurysms treated with PED at our institution between 2012 and 2017 were retrospectively reviewed...
January 1, 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/29227793/bilateral-traumatic-caroticocavernous-fistulas-a-case-report-and-review-of-the-literature
#11
Lorna Leandro, Giovanni Dolci, Satheesh Prabhu, Rufus Corkill
A traumatic caroticocavernous fistula (CCF) is an acquired, abnormal communication between the internal carotid artery and the cavernous sinus, secondary to trauma. This rare condition can initially be misdiagnosed, because its presentation shares features common to those of facial trauma, which can result in serious complications. We describe a case of bilateral CCF in an adult patient after a road traffic accident.
November 23, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29219894/crisis-management-simulation-establishing-a-dual-neurosurgery-and-anesthesia-training-experience
#12
Jeremy Ciporen, Haley Gillham, Michele Noles, Dawn Dillman, Mark Baskerville, Caleb Haley, Donn Spight, Ryan C Turner, Brandon P Lucke-Wold
BACKGROUND: Simulation training has been shown to be an effective teaching tool. Learner management of an intraoperative crisis such as a major cerebrovascular bleed requires effective teamwork, communication, and implementation of key skill sets at appropriate time points. This study establishes a first of a kind simulation experience in a neurosurgery/anesthesia resident (learners) team working together to manage an intraoperative crisis. METHODS: Using a cadaveric cavernous carotid injury perfusion model, 7 neurosurgery and 6 anesthesia learners, were trained on appropriate vascular injury management using an endonasal endoscopic technique...
January 2018: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/29218256/intracranial-anatomical-triangles-a-comprehensive-illustrated-review
#13
REVIEW
Doniel Drazin, Joy Mh Wang, Fernando Alonso, Daxa M Patel, Andre Granger, Mohammadali M Shoja, Marios Loukas, Rod J Oskouian, R Shane Tubbs
There are multiple anatomical triangles of the skull base. However, to our knowledge, there has been no comprehensive review of these geometric landmarks. To allow for a safe and consistent approach to lesions of the skull base such as those near the internal carotid artery, internal acoustic meatus, and cavernous sinus, a comprehensive review of the variations with illustrations is required. This article provides an overview of the anatomical borders, dimensions, and surgical implications as well as illustrations of the major skull base triangles...
October 4, 2017: Curēus
https://www.readbyqxmd.com/read/29205798/carotid-cavernous-fistula-after-endovascular-intervention-for-chronic-carotid-artery-total-occlusion
#14
Chih-Fan Yeh, Yin-Hsien Chen, Mao-Shin Lin, Ching-Chang Huang, Chi-Sheng Hung, Shih-Wei Meng, Chih-Kuo Lee, Hsien-Li Kao
BACKGROUND AND PURPOSE: In addition to head trauma and cranial surgery, endovascular intervention for chronic carotid artery occlusion (CAO) may also result in carotid-cavernous fistula (CCF). The management and prognosis of iatrogenic CCF during CAO recanalization have never been well described and discussed in the literature. MATERIALS AND METHODS: We conducted a retrospective analysis for CAO recanalization attempts in National Taiwan University Hospital and affiliated hospitals...
December 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29201856/complete-reversal-of-diffusion-restriction-after-treatment-of-traumatic-carotid-cavernous-fistula
#15
Jeong Hyun Shim, Inbo Han
A 15-year-old man presented with stupor following a motorcycle traffic accident. The patient was diagnosed with a traumatic left carotid cavernous fistula (CCF) with pseudoaneurysm of the left internal carotid artery. Brain magnetic resonance imaging (MRI) showed transiently restricted diffusion in the left centrum semiovale white matter and lower temporo-occipital area extending to the splenium of the corpus callosum, with high signal intensity on diffusion-weighted imaging. On the 35th day of admission, the patient had complete neurological recovery and a follow-up brain MRI revealed complete resolution of the lesions in the left centrum semiovale and splenium of the corpus callosum...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29192863/precipitating-hydrophobic-injectable-liquid-embolization-of-intracranial-vascular-shunts-initial-experience-and-technical-note
#16
Shriram Varadharajan, Arvinda Hanumanthapura Ramalingaiah, Jitender Saini, Arun Kumar Gupta, B Indira Devi, Ullas V Acharya
Precipitating hydrophobic injectable liquid (PHIL) is a newly available liquid embolic agent for endovascular therapy. It is nonadhesive and composed of a biocompatible polymer dissolved in dimethyl sulfoxide solvent and bonded covalently with iodine. In this report, the authors present their preliminary experience using PHIL in the treatment of intracranial vascular shunts. Between July 2015 and December 2015, 11 patients underwent endovascular embolization using the PHIL embolic agent. Five patients had arteriovenous malformations, 4 had dural arteriovenous fistulas, 1 patient had a carotid-cavernous fistula, and 1 patient had a pial arteriovenous fistula...
December 1, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29189199/intrasellar-cavernous-hemangioma-presenting-as-pituitary-adenoma-a-report-of-two-cases-and-review-of-the-literature
#17
Sumit Das, Lee-Cyn Ang, David Ramsay
Cavernous hemangioma in the sellar region is quite rare with only a handful of cases being reported in the English literature. Its clinical manifestations and imaging characteristics can mimic those of a pituitary adenoma. We report two cases of recurrent sellar lesions, both of which were clinically suspected of being pituitary adenomas but histologically confirmed as cavernous hemangiomas. The first case is of a 67-year-old female whose initial resection was diagnosed as "venous angioma". Neuroimaging performed 27 years later demonstrated significant growth of the lesion involving the right cavernous sinus and encasing the right internal carotid artery...
November 30, 2017: Clinical Neuropathology
https://www.readbyqxmd.com/read/29174523/transvenous-coil-embolization-for-the-treatment-of-carotid-cavernous-fistula-after-pipeline-placement-a-case-report
#18
Ryuta Nakae, Masaya Nagaishi, Issei Takano, Yoshihiro Tanaka, Akio Hyodo, Kensuke Suzuki
The Pipeline embolization device (PED), a type of flow diverter, has become an appealing alternative treatment option for large or giant and wide-necked intracranial aneurysms. Carotid cavernous fistula (CCF) resulting from delayed aneurysmal rupture is a rare complication of PED placement with unknown pathophysiology. Here, we describe a case of CCF resulting from aneurysmal rupture following PED placement, and present the details of treatment by transvenous coil embolization. An 81-year-old woman was referred to our hospital for treatment of an 18...
November 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29170837/post-traumatic-carotid-cavernous-fistula-in-a-pediatric-patient-a-case-based-literature-review
#19
Barbara Albuquerque Morais, Vitor Nagai Yamaki, Jose Guilherme Mendes Pereira Caldas, Wellingson Silva Paiva, Hamilton Matushita, Manoel Jacobsen Teixeira
BACKGROUND: Carotid-cavernous fistula (CCF) is a shunt between the carotid artery and the cavernous sinus. Traumatic CCFs are diagnosed in 0.2% of head traumas being only 4.6% of the pediatric population. Classified by Barrow in 1985, type A CCF is the most frequent, occurring in 75% of cases. Type A is characterized by direct and high-flow CCF that generally can occur as a result of traumatic injury or rupture of an intracavernous aneurysm. CASE PRESENTATION: The subject was an 8-year-old boy with penetrating trauma to his left eye...
November 23, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29146727/primary-intraventricular-haemorrhage-due-to-rupture-of-giant-varix-of-the-basal-vein-of-rosenthal-in-a-patient-with-long-standing-direct-ccf-angiographic-features-and-treatment-considerations
#20
Chinmay P Nagesh, Aneesh Mohimen, Santhosh K Kannath, Jayadevan E Rajan
Direct carotid cavernous fistulae (CCF) are often detected early and treated promptly resulting in a paucity of literature regarding its long-term evolution. We present a case of high flow post-traumatic direct CCF that was neglected for over 6 years and presented with a rare manifestation of primary intraventricular haemorrhage. Occlusions of the primary venous outlets likely resulted in engorgement of the deep venous system. The segmental anatomy of the shunting basal vein is critical to the clinical presentation and may range from basal ganglia or brainstem oedema/infarctions to uniquely, as in our case, isolated intraventricular haemorrhage secondary to variceal rupture...
November 16, 2017: BMJ Case Reports
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