Strategy for the treatment of arteriovenous malformations

Sano, Hirotoshi; Kato, Yōkō; Bannur, U; Okuma, Isao; Kanaoka, Narimasu; Kanno, Tetsuo

doi:10.1054/jocn.2000.0714

Cited by 9 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, their description suggests that the feeding arteries were clipped at a more distal location than in our series, in which we clipped M1, M2, P2, A2, A3, and A4. Similar distal feeding artery clipping has also been described by other surgeons (1,4,6). Kandel reported clipping the main arterial feeder of an AVM through a burr hole in select cases prior to radical excision at the beginning of surgery (5).…”

Section: █ Discussionsupporting

confidence: 60%

“…The authors consider this a possible limitation of the study. Sano et al (6) was also in agreement, having had a similar experience with temporary proximal artery clipping in their earlier surgical periods. Intraoperative angiography may be useful, especially for revealing concealed portions of the nidus that may be missed during resection.…”

Section: Pathophysiology Of Avm That Facilitates Temporary Proximal Asupporting

confidence: 54%

See 1 more Smart Citation

Is temporary proximal artery clipping in avm surgery safe?

Pai

Nagaraj²,

Hegde³

2018

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

Section: █ Discussionsupporting

confidence: 60%

Section: Pathophysiology Of Avm That Facilitates Temporary Proximal Asupporting

confidence: 54%

Is temporary proximal artery clipping in avm surgery safe?

Pai

Nagaraj²,

Hegde³

2018

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…More detailed technical nuances to remove AVM have been described in detail elsewhere. [ 8 ] All the data in the text are described as mean ± standard deviation (minimum – maximum).…”

Section: Methodsmentioning

confidence: 99%

Intraoperative anatomical and hemodynamic analysis of intracerebral arteriovenous malformations by semi-quantitative color-coded indocyanine green videoangiography

et al. 2017

Self Cite

View full text Add to dashboard Cite

Objective and Background:To evaluate possible roles for indocyanine green (ICG)-based FLOW 800 software in surgical treatment of cerebral arteriovenous malformations (AVMs).Methods:We perform ICG videoangiography several times for each step of AVM resection to elucidate feeders, drainers, and cerebral perfusion.Results:Since 2010, 22 AVM surgeries in our department have been conducted using FLOW 800 intraoperatively. We demonstrated ICG angiograms, color-coded images, and semi-quantitative curves for AVMs. By reviewing all these modalities, we would define vascular structure of the AVM, proceed with resection, and finally recheck for any remnant.Conclusions:ICG FLOW 800 software helps the surgeon to recognize feeding and draining vessels of an AVM intraoperatively. Further studies to evaluate semi-quantitative acquired data regarding blood flow and tissue perfusion are warranted.

show abstract

“…Radiosurgery and embolization are two other treatment options. Various combinations of the three treatment options have been reported [2][3][4][5] . Embolization may be effective to reduce the size and density of the AVM, but reaches the goal of total obliteration only …”

Section: Introductionmentioning

confidence: 99%

Combined Effects of Embolization and Hypofractionated Conformal Stereotactic Radiotherapy in Arteriovenous Malformations of the Brain

Lindvall

Wikholm²,

Bergström

et al. 2005

Interv Neuroradiol

View full text Add to dashboard Cite

There are three major treatment options for cerebral AVMs; surgery, embolization and radiosurgery. Embolization may be effective to reduce the size and density but completely obliterates AVMs only in a minority of cases. Radiosurgery may be an alternative to resection, especially in smaller AVMs. Large AVMs have been considered difficult to treat safely and effectively with single fraction radiosurgery. Hypofractionated conformal stereotactic radiotherapy (HCSRT) alone or in combination with embolization may be an alternative treatment. Embolization may reduce the volume and density of AVMs, followed by HCSRT, allowing a safe delivery of a higher total dose of radiation than possible with a single fraction. Sixteen patients with AVMs were treated with embolization and HCSRT. Embolization was performed in 1–6 (median 2) sessions. HCSRT was delivered in 5 fractions with 6–7 Gy each to the total dose of 30–35 Gy. Cerebral angiographies before and after embolization were digitally compared for calculation of volume reduction and luminescence as a measure of AVM density. The mean AVM volume in 15 patients was reduced from 11.9 ± 2.1 (1–29, median 10.0) ml to 6.5 ± 2.0 (0.5–28, median 3) ml by embolization. The luminescence for all AVMs was significantly higher after than before embolization, indicating that all AVMs were less dense after embolization. Thirteen out of 16 patients (13/16, 81%) treated with embolization and HCSRT have so far shown obliteration of their AVMs 2–9 (median 4) years after HCSRT. Three patients experienced neurological sequele after embolization, and three patients developed radionecrosis after HCSRT. Using a new method to compare cerebral angiographies in AVMs we report reduction in density and volume after embolization. The obliteration rate of a combined treatment with embolization and HCSRT seems comparable with single fraction radiosurgery although the AVMs in our series are larger than reported in most series treated with single fraction radiosurgery.

show abstract

Strategy for the treatment of arteriovenous malformations

Cited by 9 publications

References 8 publications

Is temporary proximal artery clipping in avm surgery safe?

Is temporary proximal artery clipping in avm surgery safe?

Intraoperative anatomical and hemodynamic analysis of intracerebral arteriovenous malformations by semi-quantitative color-coded indocyanine green videoangiography

Combined Effects of Embolization and Hypofractionated Conformal Stereotactic Radiotherapy in Arteriovenous Malformations of the Brain

Contact Info

Product

Resources

About