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De Lucia F, Bonnet T, Elens S. Endovascular NBCA treatment of a ruptured arteriovenous malformation with venous pseudoaneurysm in a young child. Radiol Case Rep 2023; 18:3795-3797. [PMID: 37663568 PMCID: PMC10474349 DOI: 10.1016/j.radcr.2023.08.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/06/2023] [Accepted: 08/08/2023] [Indexed: 09/05/2023] Open
Abstract
We reported imaging findings of arterio-venous malformation complicated by hemorrhage and venous pseudoaneurysm in a young child consulting for headache and emesis: to our knowledge venous pseudoaneurysm in association with ruptured arteriovenous malformation is a rare complication reported in the literature. We present the indications for endovascular treatment, especially with NBCA (N-butyl cyanoacrylate).
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Affiliation(s)
| | - Thomas Bonnet
- Department of Radiology, Hôpital Erasme, Brussels, Belgium
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Rustici A, Vari F, Sturiale C, Conti A, Scibilia A, Bortolotti C, Agati R, Tonon C, Lodi R, Mazzatenta D, Zoli M, Princiotta C, Dall’Olio M, Cirillo L. The angio-architectural features of brain arteriovenous malformations: is it possible to predict the probability of rupture? Neuroradiol J 2023; 36:427-434. [PMID: 36533312 PMCID: PMC10588602 DOI: 10.1177/19714009221140479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Hemorrhage is the most devastating complication of brain arteriovenous malformations (bAVMs), and to date, there is still concern about the needing for treatment in case of unruptured and asymptomatic bAVM. In fact, the morbidity and mortality of treatments may exceed that of the AVM's natural history. None of the classifications and scores for bAVM allows to predict the risk of bleeding. In this study, we aimed to identify the angio-architectural characteristics of brain AVMs associated with bleeding. METHODS We retrospectively evaluated all consecutive patients diagnosed with cerebral AVMs, between January 2010 and December 2019 from our prospective bAVM database. Univariate and multivariate logistic regression analysis were used to evaluate relationships between angio-architectural features of ruptured and unruptured bAVMs. RESULTS Of the 143 retrieved bAVMs, 65 were unruptured and 78 were ruptured. The univariate logistic regression analysis demonstrated statistically significant differences into angio-architectural features of unruptured and ruptured bAVMs. The multivariate logistic regression analysis fitted well (p =.113) with a good discrimination capacity (ROC = 0.83) of three independent angio-architectural features mainly related to bleeding in bAVMs: a smaller diameter of the nidus (p < .001), the absence of venous drainage alterations (p = .047), of the presence of prenidal aneurysms (p = .005). CONCLUSIONS In our study, several features resulted related to an increased probability of rupture for bAVMs, among which the more relevant were a small diameter of the nidus, the absence of venous drainage alterations, and the presence of prenidal aneurysms.
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Affiliation(s)
- Arianna Rustici
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Francesca Vari
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Carmelo Sturiale
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Alfredo Conti
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Antonino Scibilia
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Carlo Bortolotti
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
| | - Raffaele Agati
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma di Neuroradiologia con Tecniche Ad Elevata Complessità, Bologna, Italy
| | - Caterina Tonon
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Raffaele Lodi
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
| | - Diego Mazzatenta
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi, Bologna, Italia
| | - Matteo Zoli
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neurochirurgia, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi, Bologna, Italia
| | - Ciro Princiotta
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
| | - Massimo Dall’Olio
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
| | - Luigi Cirillo
- Department of Biomedical and NeuroMotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma di Neuroradiologia con Tecniche Ad Elevata Complessità, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neuroimmagini Funzionali e Molecolari, Bologna, Italy
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Programma Neurochirurgia Ipofisi, Bologna, Italia
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, UOC di Neuroradiologia, Bologna, Italy
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Fang W, Yang Z, Liu Y, Yu J, Sun P, Zhao Z, He Y, Zhang T, Deng J. Peri-procedure efficacy and safety of one-stop hybrid surgery for the treatment of brain arteriovenous malformations: A single-center preliminary experience. Front Neurol 2022; 13:1052882. [PMID: 36408526 PMCID: PMC9671923 DOI: 10.3389/fneur.2022.1052882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
Background Some deficiencies and shortcomings in treatment strategies of brain arteriovenous malformation (bAVM) remain. It is worth exploring whether the one-stop hybrid surgical platform can play a positive role in the treatment of bAVM. Objective This study investigated short clinical and angiographic results of one-stop hybrid surgery for the treatment of bAVM. Methods All patients with bAVM treated with one-stop hybrid surgery were reviewed from February 2017 to December 2021. Data including demographic information, clinical conditions, characteristics of AVM, procedure details, and clinical and angiographic results were collected. Result In total, 150 cerebral bAVM patients received one-stop hybrid surgery; among them, 122 received surgical resection assisted by intraoperative DSA, and 28 were treated with combination surgical resection and endovascular embolization. Complete angiographic obliteration of the AVM was achieved in 136 patients (90.7%), and procedure-related death and neurological deficit rates were 7.3%. Of all relevant variables, logistic regression analysis showed that the Spetzler & Martin (S&M) score was the only factor related to the cure rate (P < 0.001) and endpoint complication rate (P = 0.007). Conclusions In our preliminary experience, one-stop hybrid surgery for the treatment of brain AVMs achieves a high angiographic total occlusion rate, with acceptable peri-procedure morbidity and mortality. For S&M 4 and 5 lesions, more cases and further study are needed to investigate the effects and safety of hybrid surgery.
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Affiliation(s)
- Wei Fang
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Zijian Yang
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Yufeng Liu
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Jia Yu
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Peng Sun
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Zhenwei Zhao
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Yue He
- Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Zhang
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
- Tao Zhang
| | - Jianping Deng
- Department of Neurosurgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
- *Correspondence: Jianping Deng
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