AVM Compartments: Do they modulate trasnidal pressures? An electrical network analysis

Litao, Miguel Lorenzo Silva; Pilar-Arceo, Carlene P.C.; Legaspi, Gerardo D.

doi:10.4103/1793-5482.106649

Cited by 13 publications

(3 citation statements)

References 16 publications

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“…This would imply that the likelihood of multi-compartmental large AVM bleeding should be dictated by the smallest compartments, which might represent a more vulnerable part of the AVM. 25 This explains why in partial elimination of an AVM by surgery, embolization or radiotherapy is claimed to increase or decrease the risk of bleeding. Partial elimination, irrespective of treatment modality, can leave small compartments with a tendency to bleed, or the treatment might have eliminated the small compartments and thus reduced the risk of bleeding.…”

Section: Discussionmentioning

confidence: 99%

Update Onyx embolization for plexiform arteriovenous malformation: Ante-grade drifting technique

Liang

2020

Neuroradiol J

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Objective The conventional arteriovenous malformation (AVM) Onyx embolization technique is the extrusion Onyx injection technique, with blood-flow control after a certain distance casting through the head end of the microcatheter. This method has elevated periprocedural AVM bleeding complications. In this study, the authors reported safety and efficacy of an updated ante-grade drifting Onyx injection for plexiform AVM embolization. Methods Between January 2016 and December 2018, 101 consecutive patients with plexiform AVMs were treated with ante-grade drifting Onyx injection. The patients’ clinical status was classified using the modified Rankin Scale (mRS). To measure associations, logistic univariate or multivariate regression analyses were used. Results Complete AVM obliteration was achieved in 51.2% (52/101) of patients. Two (2/101, 2.0%) arterial perforations occurred without causing neurological deficits. In univariate and multivariate logistic regression analyses, younger patient age (odds ratio (OR) = 1.06, 95% confidence interval (CI) 1.01–1.12, p = 0.014), haemorrhagic presentation at admission (OR = 7.14, 95% CI 1.52–33.33, p = 0.013) and low Spetzler–Martin grade (OR = 10.00, 95% CI 3.45–25.00, p < 0.001) were significantly correlated with complete obliteration. Pretreatment mRS was correlated with perforation complication (OR = 3.44, 95% CI 1.05–11.29, p = 0.041) in univariate logistic regression analysis but not in multivariate logistic regression analysis (OR = 2.956, 95%CI 0.745, 11.731, p = 0.123). Patients’ clinical status was significantly improved after endovascular AVM embolization. Conclusions With ante-grade drifting Onyx injection, it was possible to prevent serious bleeding complications and elevated complete embolization rate in plexiform AVMs. Younger patient age, haemorrhagic presentation at admission and low AVM Spetzler–Martin grade were significantly correlated with complete obliteration. Although there is not enough statistical power to show that the pretreatment mRS and the arterial perforation complication have a significant correlation, but its OR value is large, and there may be more data in the future to obtain further conclusion.

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Section: Discussionmentioning

confidence: 99%

Update Onyx embolization for plexiform arteriovenous malformation: Ante-grade drifting technique

Liang

2020

Neuroradiol J

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“…The true problem is the discrimination of elective versus emergency management during pregnancy, a problem encountered in 2 of our cases, with cerebellar hematoma. Considering Spetzler-Martin scale [64], the cases represent 3 ruptured AVMs with a small size (which explains the high risk of rupture [65], yet it carries the advantage of minimizing the number of interventional sessions) and situated in the posterior fossa (which carries a higher morbidity by its eloquence) [66,67]. So rupture status, posterior location-together with the size-were the determinants among which we decided urgent timing of intervention.…”

Section: Discussionmentioning

confidence: 99%

Cranial Arteriovenous Malformations During Pregnancy: A Multidisciplinary Algorithm for Safe Management. Case Series and Review of the Literature

Mohamed¹,

Sultan²,

Tamer³

et al. 2016

JNSK

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Submit Manuscript | http://medcraveonline.com IntroductionBrain Arteriovenous malformations (AVM) are abnormal communication between parts of cranial arterial and venous systems with the lack of a true nutritive and absorptive capillary bed [1]. The universal prevalence of AVM is relatively uncommon, with a prevalence ranging from 0.01-0.5%, 10/100000 to 140-500/100000 specifically [2][3][4][5][6][7] clustering between 3 rd and 5 th decade i.e. presenting usually before 40 years old of age [4,8,9]. AVM commonly presents with hemorrhage in more than one half of the cases even during pregnancy [4,8,[10][11][12][13][14][15][16][17] AbstractBackground: Cerebral arteriovenous malformations (AVMs) are relatively uncommon lesions in general population and rare among pregnant females, meanwhile they carry a relatively higher morbidity and mortality. In view of limited data for optimal management, we try to address dilemmas commonly encountered in pregnant females with cranial AVM and propose multidisciplinary algorithms for safe management.

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“…AVM and blood flow in surrounding vessels flow interaction is often studied in analogy with electric and hydraulic networks [18][19][20]. Such models make it possible to evaluate the effect of various embolization scenarios on blood flow restructuration and are consistent with the general medical view on AVM haemodynamics.…”

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confidence: 99%

Modelling of the arteriovenous malformation embolization optimal scenario

et al. 2020

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Cerebral arteriovenous malformation (AVM) is a congenital brain vessels pathology, in which the arterial and venous blood channels are connected by tangles of abnormal blood vessels. It is a dangerous disease that affects brain functioning causing the high risk of intracerebral haemorrhage. One of AVM treatment methods is embolization—the endovascular filling of the AVM vessel bundle with a special embolic agent. This method is widely used, but still in some cases is accompanied by intraoperative AVM vessels rupture. In this paper, the optimal scenario of AVM embolization is studied from the safety and effectiveness of the procedure point of view. The co-movement of blood and embolic agent in the AVM body is modelled on the basis of a one-dimensional two-phase filtration model. Optimal control problem with phase constraints arising from medicine is formulated and numerically solved. In numerical analysis, the monotone modification of the CABARET scheme is used. Optimal embolization model is constructed on the basis of real patients' clinical data collected during neurosurgical operations. For the special case of embolic agent, input admissible and optimal embolization scenarios were calculated.

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AVM Compartments: Do they modulate trasnidal pressures? An electrical network analysis

Cited by 13 publications

References 16 publications

Update Onyx embolization for plexiform arteriovenous malformation: Ante-grade drifting technique

Update Onyx embolization for plexiform arteriovenous malformation: Ante-grade drifting technique

Cranial Arteriovenous Malformations During Pregnancy: A Multidisciplinary Algorithm for Safe Management. Case Series and Review of the Literature

Modelling of the arteriovenous malformation embolization optimal scenario

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