Intra‐operative use of super‐selective or highly selective angiography with methylene blue injection to localize arterial‐venous malformation

Stauffer, John; Shaddix, Kyle K.; Achem, Sami R.; Stark, M. Elena; Adelson, Anthony B.; Metzger, Philip P.; Landmann, Ron G.

doi:10.1111/j.1463-1318.2010.02257.x

Cited by 7 publications

(8 citation statements)

References 4 publications

(2 reference statements)

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“…Allergic airway inflammation in man induces vascular involvement of both the bronchial and the pulmonary arteries [5, 8], and remodeling of the pulmonary circulation occurs in diseases such as systemic lupus erythematosus, systemic sclerosis, chronic obstructive pulmonary disease and idiopathic PAH [9,10,11,12,13,14,15], where recent observations suggest an inflammatory component as contributing factor [18, 19, 35]. Indeed, corticosteroids and immunosuppressant drugs may improve PAH [35].…”

Section: Discussionmentioning

confidence: 99%

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Allergic Airway Inflammation Initiates Long-Term Vascular Remodeling of the Pulmonary Circulation

Rydell‐Törmänen¹,

Uller²,

Erjefält³

2009

Int Arch Allergy Immunol

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Background: Asthma and allergic airway inflammation are associated with persistent structural alterations in the bronchi, i.e. airway remodeling. Previous studies have shown that during allergic airway inflammation, similar structural alterations may also be evoked in the pulmonary circulation. However, it remained unknown whether remodeling of the pulmonary circulation is as persistent as airway remodeling. The aim of this study is to investigate the reversibility and resolution of vascular remodeling, induced by allergic airway inflammation. Methods: A validated mouse model of allergic airway inflammation, utilizing ovalbumin as allergen, was employed. Animals were sacrificed 1 day, 1 week or 1 month after the last allergen exposure, and different parameters of remodeling (smooth muscle mass, proliferation of smooth muscle cells and endothelial cells as well as number of myofibroblasts and procollagen-I-producing cells) were investigated and quantified histologically. Results: Allergen exposure resulted in allergic airway inflammation characterized by a transient leukocyte infiltration and in structural alterations in both airway and vascular compartments. The increase in vascular smooth muscle mass and endothelial proliferation persisted at 1 month after the last allergen exposure. The other parameters and cellular inflammatory response returned to baseline within 1 month after the last allergen challenge. Conclusions: Based on the findings in this study, we conclude that acute allergic airway inflammation, although being initiated from the airways, is able to evoke similar long-term structural alterations in pulmonary vessels as described for bronchi.

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Section: Discussionmentioning

confidence: 99%

“…Recent data suggest that, similar to the airways, also the pulmonary circulation is affected and undergoes remodeling as a result of allergic airway inflammation [4,5,6,7,8]. However, this remodeling, which affects the large and mid-sized pulmonary vessels, is far less studied than the structural changes in asthmatic bronchi.…”

Section: Introductionmentioning

confidence: 99%

Allergic Airway Inflammation Initiates Long-Term Vascular Remodeling of the Pulmonary Circulation

Rydell‐Törmänen¹,

Uller²,

Erjefält³

2009

Int Arch Allergy Immunol

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“…Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose [1, 2, 3, 4, 5]. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection [4].…”

Section: Discussionmentioning

confidence: 99%

“…It can be exceedingly difficult to localize and diagnose gastrointestinal tract bleeding, particularly in cases of occult small bowel AVMs [1, 2, 3, 4, 5]. Angiography and enhanced computed tomography (CT) are very useful and convenient for the detection of gastrointestinal AVMs [1, 2, 3, 4, 5]. Moreover, double-balloon endoscopy or capsule endoscopy would be also useful in the diagnosis of AVMs in the small bowel.…”

Section: Introductionmentioning

confidence: 99%

Arteriovenous Malformation Detected by Small Bowel Endoscopy

Fujii

Morita

Sutoh

et al. 2014

Case Rep Gastroenterol

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Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine.

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“…Using methylene blue to map the area of small bowel resection was described as far back as the 1970s . Several small case series have since reported successful use of the technique to localize bleeding . Fluorescein has been used as an alternative; however, this requires special equipment to enable visualization in contrast to methylene blue being obvious under standard operating theatre lighting.…”

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confidence: 99%