Objective To report three cases of vein of Galen aneurysmal malformation (VGAM) in pediatric patients treated at the hemodynamics lab of Hospital Santa Isabel (HSI) in Blumenau, state of Santa Catarina, Brazil, from 2006 to 2020. Clinical presentation, endovascular treatment, and postprocedure evolution to date are included. Case description Three children aged 5 to 12 months with cardiac, respiratory, or neurological damage in the neonatal stage, were referred to the neurosurgery service and diagnosed with VGAM. The three patients underwent endovascular embolization of the malformation, with different clinical evolution throughout outpatient follow-up. Conclusion Vein of Galen aneurysmal malformations are uncommon vascular abnormalities that, until the advent of endovascular embolization, were associated with high morbidity and mortality rates. Its prognosis is linked with initial clinic, early diagnosis, and timely surgical correction.
Background: Rhizotomy is a procedure that seeks to interrupt, the pain function of sensitive nerves. Trigeminal Neuralgia (TN) is a disease that can benefit from a trigeminal rhizotomy. Currently, percutaneous trigeminal radiofrequency rhizotomy and balloon microcompression techniques are widely used. Objective: To expose therapeutic experience of TN by trigeminal rhizotomy therapy. Methods: Retrospective study of TN patients undergoing trigeminal rhizotomy in a reference service in endovascular neurosurgery in Blumenau, Santa Catarina, from 2009 to 2019. The variables analyzed were gender, age, symptoms, comorbidities and procedural characteristics. Results: 39 patients were analyzed, 24 were women (61.5%) aged between 33 and 84 years and a mean of 62.8 years old. Regarding the symptoms presented, the most prevalent was headache (69.2%), followed by paresthesia (10.2%), tinnitus (7.7%) and dizziness (5.1%). For comorbidities, 25.6% had systemic arterial hypertension and 15.4% had dyslipidemia. The trigeminal branches most involved in rhizotomies were V2-V3 (56.4%), followed by V2 (28.2%), V1 (7.7%), V1-V2 (5.1%) and V3 (2.5%). The left side was more affected (56.4%). The percutaneous approach was performed in all patients, in 92.3% the balloon technique was performed and in 7.7% radiofrequency was used. In 79,5% of the cases, it was possible to accomplish the treatment with only one session. Conclusion: The approach of TN through rhizotomy proved to be a technique with low morbidity, reaffirming the good results of therapy. The monitoring of cases is essential to allow a better assessment of the long-term effectivenes of the treatment.
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Objectives To establish the success rate in endovascular internal carotid artery (ICA) stenosis recanalization using the double-layer stent Casper-RX (Microvention, Inc 35 Enterprise, Aliso Viejo, California, United States of America) and to identify the main comorbidities in individuals with ICA stenosis, morphological characteristics of the stenosis, diagnostic methods, intraoperative complications, as well as morbidity and mortality within 30 days of the surgical procedure. Materials and Methods Retrospective analysis of 116 patients undergoing ICA angioplasty with a degree of stenosis ≥ 70% using Casper-RX stenting who underwent this procedure from April 2015 to December 2019. Results Technical success was achieved in 99.1% of the patients. Three of them had postprocedural complications: one transient ischemic attack (TIA) and two puncture site hematomas. A cerebral protection filter was not used in only two procedures, as these consisted of dissection of the carotid. There was satisfactory recanalization and adequate accommodation of the stents in the previously stenosed arteries, with no restenosis in 99.4% of the cases. Conclusion The endovascular treatment of extracranial carotid stenoses using the Casper-RX stent showed good applicability and efficacy. Although only two cases of thromboembolic complications occurred during the procedure, further investigation and studies on the effectiveness of this new device are needed.
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