دورية أكاديمية
Normalization of Peri-Arteriovenous Malformation Hemodynamics Prior to Direct Microsurgery: 2-Dimensional Operative Video.
| العنوان: | Normalization of Peri-Arteriovenous Malformation Hemodynamics Prior to Direct Microsurgery: 2-Dimensional Operative Video. |
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| المؤلفون: | Rahme RJ; Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Turcotte EL; Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Patra DP; Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Welz ME; Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA., Batjer HH; Neurological Surgery, Southwestern Medical Center, University of Texas, Dallas, Texas, USA., Bendok BR; Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona, USA.; Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.; Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, Arizona, USA.; Department of Otolaryngology, Mayo Clinic, Phoenix, Arizona, USA.; Department of Radiology, Mayo Clinic, Phoenix, Arizona, USA. |
| المصدر: | Operative neurosurgery (Hagerstown, Md.) [Oper Neurosurg (Hagerstown)] 2021 Nov 15; Vol. 21 (6), pp. E541-E542. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 101635417 Publication Model: Print Cited Medium: Internet ISSN: 2332-4260 (Electronic) Linking ISSN: 23324252 NLM ISO Abbreviation: Oper Neurosurg (Hagerstown) Subsets: PubMed not MEDLINE; MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : [Philadelphia] : Lippincott Williams & Wilkins, Inc. Original Publication: Hagerstown, MD: Lippincott, Williams & Wilkins, 2014- |
| مستخلص: | Arteriovenous malformations (AVMs) are highly complex vascular lesions characterized by abnormal connections between arteries and an intervening nidus. Definitive and safe treatment of AVMs may require the combination of multiple treatment modalities to address the various complex features of the AVM.1 Endovascular embolization can be used as an adjuvant to surgery in order to control deep feeders, reduce flow, and address high-risk features such as aneurysms. In addition, by progressively reducing the AVM flow, staged embolization can lead to normalization of peri-AVM hemodynamics and therefore may decrease the risk of postresection hemorrhage.2,3 In this operative video, we present a case of a 41-yr-old female who presented with progressively worsening left-sided hemiparesis. Magnetic resonance imaging (MRI) and angiography revealed a complex right fronto-parietal AVM with significant associated edema, likely due to the vascular steal phenomenon. The area of edema, which included the motor cortex, was thought to be at high risk for postoperative hemorrhage from normal perfusion pressure breakthrough. We therefore decided to proceed with staged presurgical embolization to gradually normalize the perilesional hemodynamics, and therefore possibly reduce the risk of postoperative morbidity. The patient underwent 3 embolization sessions at 6-wk intervals. An MRI after the last embolization showed near-complete resolution of the fluid-attenuated inversion-recovery (FLAIR) signal around the AVM. Microsurgical resection was performed on the day after the last embolization. The patient tolerated the procedure well and was discharged at her neurological baseline with mild contralateral hemiparesis, which has continued to improve at follow-up. Postoperative angiography showed complete resection of the AVM. The patient consented to the procedure as shown in this operative video and gave informed written consent for use of her images in publication. (© Congress of Neurological Surgeons 2021.) |
| فهرسة مساهمة: | Keywords: Arteriovenous malformation; Intracerebral hemorrhage; Stroke; Subarachnoid hemorrhage |
| تواريخ الأحداث: | Date Created: 20210924 Latest Revision: 20220307 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1093/ons/opab302 |
| PMID: | 34560779 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2332-4260 |
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| DOI: | 10.1093/ons/opab302 |