BACKGROUND AND PURPOSE:Normal hemodynamic features of the superior petrosal sinus and their relationships to the SPS drainage from cavernous sinus dural arteriovenous fistulas are not well known. We investigated normal hemodynamic features of the SPS on cerebral angiography as well as the frequency and types of the SPS drainage from CSDAVFs.
Selective transarterial embolization is an effective technique for arterial bleeding from third molar removal when it is difficult to obtain hemostasis by dental procedures. Injection of NBCA can be useful when the alveolar artery is too small to embolize with coils.
Objectives
To clarify characteristic angiographic features and clinical efficacy of selective transarterial embolization (TAE) of retained placenta with abnormal vaginal bleeding.
Methods
The study cohort comprised 22 patients (mean age, 33.5 years; range, 22–24 years) who underwent selective TAE for retained placenta with abnormal bleeding between January 2018 and December 2020 at our institution. Angiographic images were reviewed by two certified radiologists with consensus. Medical records were reviewed to evaluate the efficacy of TAE. Angiographic features of retained placenta, technical success (disappearance of abnormal findings on angiography), complications, clinical outcomes (hemostatic effects and recurrent bleeding) were evaluated.
Results
Pelvic angiography showed a dilated vascular channel mimicking arteriovenous fistulas or an aneurysm contiguous with dilated uterine arteries in the mid-arterial–capillary phase in 20 patients; it showed contrast brush in the remaining two patients. TAE technical success was achieved in all patients. No major complications were observed in any patients. Fifteen patients were followed up with expectant management after TAE; all but one patient showed no re-bleeding during the follow-up period (mean follow-up interval, 3.4 months; range, 1–17 months). One patient showed minor rebleeding, which resolved spontaneously. Seven patients underwent scheduled hysteroscopic resection within 1 week after TAE, and no excessive bleeding was observed during or after the surgical procedure in all seven patients.
Conclusions
The characteristic angiographic feature of retained placenta is “dilated vascular channel that mimic low flow AVM.” TAE is a safe and effective treatment to manage retained placenta with abnormal bleeding.
Objective: Objectives: To investigate embolic complications related to carotid artery stenting (CAS) under Angioguard XP fi lter protection, and analyze the relationship between several potential risk factors and complications. Methods: Forty-eight patients with 49 carotid stenoses, that underwent MR plaque imaging before CAS under Angioguard XP fi lter protection, were retrospectively reviewed. Embolic complications during CAS and MR plaque images, including signal ratio of the plaque to posterior cervical muscle (P/M ratio) and submandibular gland (P/S ratio) on T1 and T2 weighted images, were reviewed. Relationships between embolic complications and P/M, P/S ratios, and length of lesions were analyzed. Results: Ten slow fl ow (20.4%), 3 embolism (6.1%), and 4 spasm (8.1%) incidents occurred during the procedures. All embolisms occurred concurrently with slow fl ow. T1 P/M ratio and T1 P/S ratio in patients with an embolism tended to be higher than those without (2.33 vs 1.62, p=0.107, 1.78 vs 1.19, p=0.092, respectively). T2 P/M ratio and T2 P/S ratio in patients with slow fl ow tended to be lower than those without (1.60 vs 2.49,p=0.259, 0.68 vs 0.96,p=0.328, respectively). Mean length of the stenosis was longer in cases with an embolism or slow fl ow, compared to cases without an embolism or slow fl ow (27.3 vs 20.2mm, p=0.153, 24.2 vs 19.7, p=0.130, respectively). Cases with plaque length 25mm and T1 P/M ratio 1.5 showed a statistically signifi cant high risk of an embolism (p=0.003). Conclusion: Plaque imaging fi ndings and plaque length appeared to be related to embolic complications. Patients with plaques showing a high T1 P/M ratio 1.5 with long stenosis 25mm have a greater risk of an embolic complication. Techniques to be applied and indications for CAS need careful consideration in such cases.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.