Artificial Embolization of Cerebral Arteries

Luessenhop, Alfred J.; Spence, William T.

doi:10.1001/jama.1960.63020110001009

Cited by 339 publications

(18 citation statements)

References 2 publications

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“…The first case of transcatheter embolization therapy was performed in 1960 by Luessenhop et al [31]. They reported a 47-year-old woman with cerebral arteriovenous malformation and was treated by injecting spherical plastic emboli into the carotid artery.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter closure of coronary artery fistula using Guglielmi detachable coil

Munawar¹,

Siswanto²,

Harimurti³

et al. 2012

Journal of Geriatric Cardiology

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BackgroundCoronary artery fistula (CAF) is a rare anomaly. Transcatheter CAF closure has been introduced using various materials, but only few data are available on the Guglielmi detachable coil (GDC). The advantage of using GDC for transcatheter CAF closure is more controllable, therefore much safer when compared to other coils. This report is about our experience in transcatheter closure of CAF using fibered GDC in our hospital.Methods & ResultsFrom 2002 to 2007, there were 10 patients with CAFs (age range: 28 to 56 year-old, 7 males) who underwent transcatheter CAF closure. There were a total of 19 CAFs which originated from right coronary (n = 5), left circumflex (n = 3), left anterior descending artery (n = 10) and left main trunk (n = 1). Median number of coil deployment for each fistula was 3 (range: 1 to 6). The pulmonary artery was the most common site of the distal communication of CAFs (n = 14), followed by right atrium (n = 3), left atrium (n = 1) and left ventricle (n = 1). Immediate coronary angiography after GDC deployment revealed no residual shunt in 12 (63.2%) CAFs, significant reduction of the flow in 5 (26.3%), while 2 (10.5%) could not be closed due to small size. Nine (90%) patients underwent a repeated angiography within 3 to 8 months. Among 12 CAFs that were occluded immediately post-deployment, there were 2 CAFs with insignificant residual flow. Among 6 CAFs with significantly decreased flow immediately post-deployment, 2 were occluded totally in the follow-up angiography. In total, 12 (70.5%) CAFs were occluded completely and 5 (29.5%) CAFs still had insignificant residual flow, which did not need any additional coil deployment. During a mean follow up of 4.3 ± 0.7 year, all patients remained symptom and complication free.ConclusionsThe fibered GDC is a safe and effective method for percutaneous closure of the CAFs.

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Section: Discussionmentioning

confidence: 99%

Transcatheter closure of coronary artery fistula using Guglielmi detachable coil

Munawar¹,

Siswanto²,

Harimurti³

et al. 2012

Journal of Geriatric Cardiology

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“…The temporal bone equivalent is, however, considered to be radiosensitive22 and, although several factors must be considered (e.g., site, size, multiplicity, metastases) before a management plan is decided on, radiotherapy is most likely to play a role in the management of large glomus jugulare turn or^.^^^^^ Small glomus tympanicum tumors, as our patient demonstrated, are well managed either surgically (control rate of more than 90%) or with radiotherapy (control rate of more than 95%). 28 In excising vagal tumors, the vagus nerve must almost always be sacrificed, but rarely is it necessary to sacrifice adjacent structure~.~ In all reported cases in which the vagus nerve was anatomically preserved, no function could be demonstrated postoperatively.' The major problems with the surgical management of these tumors are gaining adequate exposure and maintaining hemostasis.…”

Section: Discussionmentioning

confidence: 99%

Glomus Vagale Tumors

Davidson

Gullane

1988

Otolaryngol.--head neck surg.

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We present a case of a multicentric chemodectoma, with the unusual combination of a glomus vagale and a glomus tympanicum tumor. Multicentricity was suspected before selective carotid arteriography. Our patient, although asymptomatic, had elevated levels of urinary catecholamines preoperatively, which returned to normal postoperatively, suggesting biochemical activity of the tumor. Intraoperative hemostasis was assisted by the use of preoperative selective embolization of the tumor mass and the peripheral location of the injected Ivalon was confirmed histologically. The vagus nerve was anatomically spared and complete function was restored within 10 months. The asymptomatic small glomus tympanicum tumor was treated with embolization alone, as the patient chose to defer treatment at this time, but only time will reveal the effectiveness of this method of management.

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“…Therapeutic embolization of a brain AVM was first described in 1960 by Luessenhop and Spence [34] utilizing flow-directed steel spheres covered with methyl methacrylate injected directly into a surgically accessed cervical internal carotid artery. This technique relied on the proportionately greater degree of blood flow to the AVM compared with normal cerebral branches to direct the embolic agents into the AVM nidus.…”

Section: Embolization Of Brain Avmsmentioning

confidence: 99%

Endovascular Management of Arteriovenous Malformations of the Brain

Bruno¹,

Meyers

2012

Intervent Neurol

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Arteriovenous malformations (AVMs) of the brain are rare, complex, vascular lesions that can result in significant morbidity and mortality. Modern treatment of brain AVMs is a multimodality endeavor, requiring a multidisciplinary team with expertise in cerebrovascular neurosurgery, endovascular intervention, and radiation therapy in order to provide all therapeutic options and determine the most appropriate treatment regimen depending on patient characteristics and AVM morphology. Current therapeutic options include microsurgical resection, radiosurgery (focused radiation), and endovascular embolization. Endovascular embolization is primarily used as a preoperative adjuvant before microsurgery or radiosurgery. Palliative embolization has been used successfully to reduce the risk of hemorrhage, alleviate clinical symptoms, and preserve or improve neurological function in inoperable or nonradiosurgical AVMs. Less frequently, embolization is used as ‘primary therapy' particularly for smaller, surgically difficult lesions. Current embolic agents used to treat brain AVMs include both solid and liquid agents. Liquid agents including N-butyl cyanoacrylate and Onyx are the most commonly used agents. As newer embolic agents become available and as microcatheter technology improves, the role of endovascular treatment for brain AVMs will likely expand.

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Artificial Embolization of Cerebral Arteries

Cited by 339 publications

References 2 publications

Transcatheter closure of coronary artery fistula using Guglielmi detachable coil

Transcatheter closure of coronary artery fistula using Guglielmi detachable coil

Glomus Vagale Tumors

Endovascular Management of Arteriovenous Malformations of the Brain

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