Correlation between intravascular pressure and risk of hemorrhage due to arteriovenous malformations

Miyasaka, Yoshio; Yada, Kenzoh; Kurata, Akira; Tokiwa, Kaichi; Irikura, Katsumi; Tanaka, Ryusui; Ohwada, Takashi; Kitahara, Takao

doi:10.1016/0090-3019(93)90202-c

Cited by 35 publications

(21 citation statements)

References 12 publications

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“…Several theoretical conjectures remain largely untested, while direct computation has only given solutions either accurately over a few generations or with limited detail over more generations (see Hademenos et al 1996;Pries et al 1998;Goldman & Popel 2000;Smith & Jones 2003). Related branching or network studies have been conducted with some success by Handa et al (1993), Miyasaka et al (1993), Pedley et al (1994), Gatlin et al (1995), Young et al (1996), Gao et al (1997), Hademenos & Massoud (1997), Wilquem & Degrez (1997), Zhai et al (1997), Pries et al (1998), Brada & Kitchen (2000), Kassab et al (2000), Lorthois et al (2000), McEvoy et al (2000), Cassidy et al (2001) and Comer et al (2001). The presence of an arteriovenous malformation in a cranial system eventually requires study of the application of type I within the wider framework of an application similar to type II.…”

Section: Introductionmentioning

confidence: 99%

Multi-branching flows from one mother tube to many daughters or to a network

Bowles

Dennis

Purvis

et al. 2005

Phil. Trans. R. Soc. A.

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Multiply branching fluid flows are modelled in two contexts. The first (type I) is for oneto-many branching. Computations are described for flow through a channel, with fully developed motion upstream, which branches abruptly into a number of subchannels downstream. The differences in pressure between the upstream end of the channel and the downstream ends of the subchannels are substantial. Comparisons with recent analytical predictions show fair agreement for Reynolds numbers in the low tens and above. The second context (type II) has successive generations of bifurcation in a network. Modelling, computations and analysis include the effects of many bifurcations.

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Section: Introductionmentioning

confidence: 99%

Multi-branching flows from one mother tube to many daughters or to a network

Bowles

Dennis

Purvis

et al. 2005

Phil. Trans. R. Soc. A.

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“…DVP was significantly higher in AVMs with hemorrhage (n=13; mean [±SD], 26±7 mm Hg) than in those without (n=6; mean, 13 ±5 mm Hg) (P=.001, unpaired / test). The FAP was significantly higher in the former (60±12 mm Hg) than in the latter (38±4 mmHg) (P=.0007), 2 although still lower than the normal range. may contribute to the development of hemorrhage from AVMs and support our earlier report 1 that AVMs with only one draining vein are susceptible to hemorrhage.…”

Section: S S P -mentioning

confidence: 92%

“…Patient 2 in the present study corresponds to case 5 in the previous report 2 ; patients 1 and 3 have not been described previously.…”

Section: S S P -mentioning

confidence: 95%

“…Pressure measurements were performed by the same methods that we have previously described in detail. 2 After opening of the dura and before AVM dissection, the intravascular pressures of the feeding artery, draining vein, and sagittal sinus, into which the draining vein flowed, were recorded simultaneously. Needles (26-gauge) were inserted into these vessels with the aid of microscopic visualization.…”

Section: Case Reportsmentioning

confidence: 99%

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Draining vein pressure increases and hemorrhage in patients with arteriovenous malformation.

Miyasaka

Kurata

Tokiwa

et al. 1994

Stroke

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Recent radiological studies have shown that arteriovenous malformations with impaired venous drainage may be susceptible to hemorrhage. To evaluate this hypothesis using a hemodynamic approach, we measured intravascular pressure during surgery in three patients with arteriovenous malformation. In three patients we measured intravascular pressures in the draining venous system and the feeding arteries simultaneously before removal of arteriovenous malformations with marked segmental stenotic or occlusive draining veins and evidence of hemorrhage. The draining vein pressures at prestenotic (or preocclusive) sites in the three patients were 38, 25, and 40 mm Hg, respectively, all significantly above the normal cortical venous pressure, whereas pressure measurements in poststenotic sites and the sagittal sinus pressure in the venous drainage system approached normal values. The feeding artery pressures in the patients were lower than normal cortical artery pressure because of the arteriovenous shunt. Intraoperative vascular pressure measurements support the hypothesis that arteriovenous malformations with impaired venous drainage may be associated with a local increase in venous pressure and thus may be susceptible to hemorrhage.

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“…Previous studies have suggested that increased resistance in the venous drainage system may contribute to the development of hemorrhage secondary to AVMs. 10) In this case, the varix continuing the major draining pathway might have compensated for the intranidal pressure, so early occlusion of the varix before the obliteration of the nidus could have resulted in increased venous and intranidal pressure, and thus induced the hemorrhages. Preexisting partial thrombosis in the varix and stenoses in the draining system indicate that the patient has a natural high risk of bleeding, with or without radiosurgery.…”

Section: Discussionmentioning

confidence: 99%

Rupture of Pial Arteriovenous Malformation Associated With Early Thrombosis of the Draining System Following Stereotactic Radiosurgery. Case Report.

Shimizu

Irikura

Miyasaka

et al. 2001

Neurol. Med. Chir.(Tokyo)

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A 50-year-old man was treated with stereotactic gamma knife radiosurgery for an incidentally detected small callosal arteriovenous malformation (AVM) with stenosis of the main draining pathway. He suffered two episodes of intraventricular hemorrhage at 4 and 14 weeks after the radiosurgery. Radiological studies demonstrated that the anterior portion of the draining system including a varix, which had been irradiated, was thrombosed before the obliteration of arteriovenous shunts. Stereotactic radiosurgery is an accepted treatment for selected small and medium AVMs, but this procedure may increase the risk of bleeding. Early occlusion of a part of the draining pathway after stereotactic radiosurgery might have induced AVM rupture. An impaired venous outlet, either consisting of one draining vein or with stenosis, present before treatment may be develop thrombosis in response to high-dose irradiation.

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Correlation between intravascular pressure and risk of hemorrhage due to arteriovenous malformations

Cited by 35 publications

References 12 publications

Multi-branching flows from one mother tube to many daughters or to a network

Multi-branching flows from one mother tube to many daughters or to a network

Draining vein pressure increases and hemorrhage in patients with arteriovenous malformation.

Rupture of Pial Arteriovenous Malformation Associated With Early Thrombosis of the Draining System Following Stereotactic Radiosurgery. Case Report.

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