C57BL/6J mice demonstrated greater susceptibility to vertebrobasilar dolichoectasia induction than SV129 mice.
The proportion of subjects developing saccular aneurysms in addition to IADE in our mouse model is similar to the 15% of patients with IADE who have concomitant saccular aneurysms.
aneurysms in 12 patients (92.3%), although re-bleeding occurred in eight (42.1%) during follow-up (mean, 67.4 ± 38.9 months). The re-bleeding involved contralateral hemispheres in 6 patients (75.0%), and all re-bleeding events occurred >6 months after initial hemorrhages. In the other 58 subjects without aneurysm, 13 (22.4%) also suffered rebleeding (mean follow-up, 71.9 ± 46.3 months). Conclusion Although endovascular interventions are appropriate for ruptured aneurysms of collateral arteries in MMD, conservative treatment can be a viable alternative for technically inaccessible lesions. However, the re-bleeding rate in hemorrhagic MMD was higher in the presence of the aneurysms. Introduction/purpose Despite benign histology, many congenital intra-orbital lesions have an aggressive prognosis owing to the confined orbital space and the intimate optic nerve association -resulting in pain, disfigurement, and vision loss. Complete surgical excision while preserving function may not be possible 1 The use of conventional fluoroscopically guided interventions is limited due to inability to visualize soft tissue anatomy. We have previously presented our work evaluating the feasibility of applying interventional MRI technology to access and treat these challenging intraorbital lesions, and now present an update with new patients and multi-year follow up. Materials and methods Ten MRI-guided sclerotherapy procedures were performed on 4 patients (4M, 0F, age = 3-30y) presenting with cystic congenital intraorbital lesions. Patients presented with proptosis (n = 3), visual impairment (n = 2), diplopia (n = 1), ecchymosis (n = 2), and/or pain (n = 1). All procedures were exclusively performed within an interventional MRI suite with an in-room monitor used for real-time needle guidance, injection monitoring and bedside scanner operation. A 22 g MR-compatible needle was inserted into the targeted lesions under "MR-fluoroscopy" using triorthogonal image plane guidance 2 to interactively monitor the needle on continuously updated sets of true-FISP images (TR/TE, 4.35/2.18; FA, 60°; NSA, 3; TA, 3.11 s/slice). 0.6% gadolinium was mixed with 5% Ethanolamine Oleate (Ethamolin ® ) (0.15 ml:1.0 ml vol.) and injected under real-time monitoring using a triorthogonal FLASH sequence (TR/TE,2484/5.4). Follow up on the earliest patients is available for three years. Results Intra-orbital needle insertion and subsequent repositioning were sucesfully performed in all cases. The flexibility of triorthogonal guidance was most helpful in accessing the intraconal retrobulbar space. Active monitoring of sclerosing agent was persistently achieved on 3 planes. Targeted lesions ranged between 1.5 and 4 cm. Three lesions encircled/abutted the optic nerve. Between 1-5.5 mls of sclerosing material were injected per procedure. The smallest lesion was completely filled with sclerosant during each of 2 treatment sessions, with 3 partially filled to avoid excessive intraorbital pressure. Local edema and bruising were a standard finding for 1-2 weeks afterwa...
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