Curative and adjunctive AVM Onyx embolization of AVMs through the choroidal arteries

Lv, Xianli; Hu, Xinyu; Li, Wei; He, Hong; Jiang, Chuhan; Li, Youxiang

doi:10.1177/1591019917706052

Cited by 17 publications

(15 citation statements)

References 12 publications

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“…Good outcomes can be achieved with AVM embolization. For instance, in 2017, Lv et al performed 4 AVM embolizations through the AChA; among these cases, 3 AVMs achieved curative embolization, and fourth case was a pre-surgical adjunctive procedure 70 .…”

Section: Arteriovenous Malformationsmentioning

confidence: 99%

Clinical importance of the anterior choroidal artery: a review of the literature

Xu¹,

Zhao²,

Yu³

2018

Int. J. Med. Sci.

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The anterior choroidal artery (AChA) is a critical artery in brain physiology and function. The AChA is involved in many diseases, including aneurysm, brain infarct, Moyamoya disease (MMD), brain tumor, arteriovenous malformation (AVM), etc. The AChA is vulnerable to damage during the treatment of these diseases and is thus a very important vessel. However, a comprehensive systematic review of the importance of the AChA is currently lacking. In this study, we used the PUBMED database to perform a literature review of the AChA to increase our understanding of its role in neurophysiology. Although the AChA is a small thin artery, it supplies an extremely important region of the brain. The AChA consists of cisternal and plexal segments, and the point of entry into the choroidal plexus is known as the plexal point. During treatment for aneurysms, tumors, AVM or AVF, the AChA cisternal segments should be preserved as a pathway to prevent the infarction of the AChA target region in the brain. In MMD, a dilated AChA provides collateral flow for posterior circulation. In brain infarcts, rapid treatment is necessary to prevent brain damage. In Parkinson disease (PD), the role of the AChA is unclear. In trauma, the AChA can tear and result in intracranial hematoma. In addition, both chronic and non-chronic branch vessel occlusions in the AChA are clinically silent and should not deter aneurysm treatment with flow diversion. Based on the data available, the AChA is a highly essential vessel.

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Section: Arteriovenous Malformationsmentioning

confidence: 99%

Clinical importance of the anterior choroidal artery: a review of the literature

Xu¹,

Zhao²,

Yu³

2018

Int. J. Med. Sci.

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“…[7,24] From a literature review of AVMs with embolization through the PChoA, Ezura et al reported the first safe embolization case of thalamic AVM through the PChoA as adjunctive embolization followed by GKS in 1992; [5] however, only a few reports of AVMs embolized through PChoA have been reported. [2,5,9,14,26,27] The location of AVMs embolized from PChoA included the ventricle, splenium, thalamus, and temporal lobe. [4,14,26] In addition, Onyx and NBCA were the main embolic agents.…”

Section: Discussionmentioning

confidence: 99%

Successful embolization of ventricular arteriovenous malformation supplied by the choroidal artery: A case report and literature review

Mochizuki¹,

Ryu²,

Sato³

et al. 2023

Surgical Neurology International

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Background: Ventricular arteriovenous malformations (AVMs) are localized in the ventricles and are mainly fed by the anterior choroidal artery (AChoA) and posterior choroidal artery (PChoA). Surgical resection of ventricular AVMs is difficult as the lesions are localized deep in the brain. Therefore, endovascular treatment is expected to treat ventricular AVMs. However, embolization from the AChoA and PChoA carries the risk of ischemic complications. Even though there are some major reports on embolization strategies from the choroidal arteries, embolization of these arteries remains technically challenging. In this article, we report two successful cases of ventricular AVM embolization using AChoA and PChoA. Case Description: Case 1: A 34-year-old male presented with intraventricular hemorrhage (IVH). Subsequently, ventricular AVM embolization in the anterior horn was performed using n-butyl-2-cyanoacrylate (NBCA) through the AChoA and medial PChoA, and complete obliteration was observed without neurological deterioration. Case 2: A 71-year-old female presented with IVH. Subsequently, ventricular AVM embolization in the lateral ventricle was performed through the AChoA and lateral PChoA with Onyx and NBCA, and partial obliteration was observed without complications. Furthermore, Gamma Knife surgery for residual lesions resulted in complete obliteration. Conclusion: Embolization through the choroidal arteries for ventricular AVMs is an effective curative or adjunctive treatment.

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“…Surgical resection, radiotherapy, and endovascular treatment are available therapeutic methods for AVM [18]. Embolization with the microcatheter performed as a curative procedure through the MPChA should be taken with the main aim to secure the weak structures [18,19]. existence of ventricular microaneurysms in the choroidal arteries [23].…”

Section: Discussionmentioning

confidence: 99%

Microanatomical study of the posterior medial choroidal artery

et al. 2023

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Introduction/Objective. The aim of this study was a detailed examination of microanatomy of the medial posterior choroidal artery (MPChA). Methods. The microanatomical characteristics of the MPChA were studied in 30 formalin fixed brain hemispheres using ? 6.3 to ? 10 magnification of the stereoscopic microscope. The arteries were injected with the mixture of 10% India ink and gelatin. The second group of 10 hemispheres consisted of specimens injected with methylmethacrylate fluid into the cerebral arterial vessels, for the preparation of corrosion casts. Results. The MPChA was present in all 30 hemispheres, always as the single artery. The MPChA were divided into proximal and distal types of vessels. We distinguished two segments of the MPChA: a cisternal and plexal. Proximal MPChA was present in 53.3% of cases, with the caliber of 0.6-1.0 mm (mean 0.8 mm). ?he point of its origin from the posterior cerebral artery was always before the origin of the first temporal cortical branch. Distal MPChA existed in 46.7% of cases, with the diameter of 0.4-1.0 (mean 0.74 mm). The cisternal segment the most frequently gave of the origin of fine branches to the cerebral crus, medial geniculate body and thalamus. The plexal segment gave rise arteries to the thalamus, and choroid branches for the supply of the choroid plexus of the third ventricle. Anastomoses in the region of the MPChA were found in all of 20 examined brains, most often among the plexal branches. Conclusion. The results describing the microanatomical characteristics of the MPChA may have diagnostic and microsurgical significance.

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Curative and adjunctive AVM Onyx embolization of AVMs through the choroidal arteries

Cited by 17 publications

References 12 publications

Clinical importance of the anterior choroidal artery: a review of the literature

Clinical importance of the anterior choroidal artery: a review of the literature

Successful embolization of ventricular arteriovenous malformation supplied by the choroidal artery: A case report and literature review

Microanatomical study of the posterior medial choroidal artery

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