Intravascular pressure measurements in feeding pedicles of brain arteriovenous malformations

Henkes, Hans; Gotwald, Thaddaeus; Brew, Stefan; Miloslavski, E.; Kammerer, Frederick; Kühne, D.

doi:10.1007/s00234-005-0022-7

Cited by 14 publications

(11 citation statements)

References 23 publications

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“…found a lower difference between the Mean Arterial Pressure (MAP) and Feeding Artery Pressure (FAP) in hemorrhagic, small, and single draining AVMs. [1] These findings corroborate Spetzler's study that small AVMs had higher feeding artery pressures and larger hemorrhage volumes than larger AVMs. [2] In addition, Henkes et al .…”

Section: Introductionsupporting

confidence: 84%

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

2012

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Background:Arteriovenous malformation (AVM) compartments are thought as independently fed, hemodynamically independent components of the AVM nidus. Its possible role in modulating transnidal pressures have not been investigated to our knowledge.Objective:To investigate if AVM compartments play a role in modulating transnidal pressures by using electrical models as a method of investigation.Materials and Methods:Monocompartmental and multicompartmental AVM models were constructed using electrical circuits- building on Dr. Guglielmi's previous work. Each compartment was fed by two feeding arteries (resistors) and had a shared draining vein with other compartments in the AVM nidus. Each compartment is composed of a series of resistors which represents the pressure gradient along the AVM (arterial, arteriolar, venular, and venous). Pressure (voltage) readings were obtained within these nidal points.Results:The pressure gradient (venous-arterial) is more as there are less AVM compartments in the nidus model. The monocomparmental model had a pressure gradient of 66mmHg (V); while it was 64, 61, and 59 for the 2-, 3-, and 4-compartment models, respectively. In addition, the more the number of compartments, the greater the flow (mA) is in the whole AVM nidus, 33 ml/min for the monocompartmental AVM and 121ml/min for the 4-compartment AVM; though there was greater flow per compartment as there were less compartments, 33ml/min per compartment for the monocompartmental model versus 29ml/min for the 4-compartment model.Conclusion:Transnidal pressure gradients may be less the more compartments an AVM has. This electrical model represents an approach that can be used in investigating the hemodynamic contributions of AVM compartments.

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Section: Introductionsupporting

confidence: 84%

“…[1–5] Hemodynamic factors that have been studied include feeding artery and draining vein pressures.…”

Section: Introductionmentioning

confidence: 99%

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

2012

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“…Distal mean arterial pressure at the site of polymer injection amounted to approximately 40 mmHg corresponding to 50% of the systemic arterial pressure. Henkes and colleagues also made pressure measurements in arterial feeders of arteriovenous malformations during endovascular treatment procedures [17]. A total of 148 measurements were performed in 139 patients.…”

Section: Pressure Measurementsmentioning

confidence: 99%

Recent progress understanding pathophysiology and genesis of brain AVM—a narrative review

Steiger

2021

Neurosurg Rev

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Considerable progress has been made over the past years to better understand the genetic nature and pathophysiology of brain AVM. For the actual review, a PubMed search was carried out regarding the embryology, inflammation, advanced imaging, and fluid dynamical modeling of brain AVM. Whole-genome sequencing clarified the genetic origin of sporadic and familial AVM to a large degree, although some open questions remain. Advanced MRI and DSA techniques allow for better segmentation of feeding arteries, nidus, and draining veins, as well as the deduction of hemodynamic parameters such as flow and pressure in the individual AVM compartments. Nonetheless, complete modeling of the intranidal flow structure by computed fluid dynamics (CFD) is not possible so far. Substantial progress has been made towards understanding the embryology of brain AVM. In contrast to arterial aneurysms, complete modeling of the intranidal flow and a thorough understanding of the mechanical properties of the AVM nidus are still lacking at the present time.

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“…However, once again the literature is controversial, although most studies establish a relationship between small nidus size and hemorrhage 2,8,10,[21][22][23][24][25][26][27][28] . At first it was believed that, because larger AVMs include more frequently the cortex, the occurrence of seizure and focal neurological deficit as symptoms could be more common 29 .…”

Section: Fig 2 Angiogram Of a 34-year-old Female Patient Showing Lefmentioning

confidence: 99%

Angioarchitecture and clinical presentation of brain arteriovenous malformations

Santos

Júnior²,

Matos

et al. 2009

Arq. Neuro-Psiquiatr.

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-The purpose of this study was to correlate the angioarchitecture of brain arteriovenous malformations (AVM) with their clinical presentation. A total of 170 patients with AVM 78 males and 92 females, were studied. Univariate and multivariate analyses were conducted in order to test the associations between morphological features and clinical presentation. The most frequent clinical presentations at diagnosis were hemorrhage in 89 (52%) patients, headache in 79 (46%), focal neurological deficit in 54 (32%), and seizure in 52 (31%). According to the Spetzler-Martin classification, grade I was found in 15 patients, II in 49, III in 55, IV in 41, and grade V in 10 patients. AVM with small nidus size, single feeding artery and single draining vein were associated with hemorrhage. Hemorrhage was positively associated with Spetzler-Martin grade I and negatively with grade V. The association between seizure and large nidus size was positive, however negative with small nidus size.Key wordS: brain arteriovenous malformations, angioarchitectural features, clinical presentation. Angioarquitetura e apresentação clínica de malformações arteriovenosas encefálicasResumo -o objetivo deste estudo foi correlacionar a angioarquitetura de malformações arteriovenosas encefálicas (MAV) com sua apresentação clínica. Foram estudados 170 pacientes portadores de MAV, sendo 78 do sexo feminino e 92 do masculino. Análises univariada e multivariada foram efetuadas para testar associações entre características morfológicas e quadro clínico. As principais formas de apresentação clínica no momento do diagnóstico incluíram hemorragia em 89 (52%) pacientes, cefaléia em 79 (46%), déficit focal em 54 (32%) e convulsão em 52 (31%). de acordo com a classificação de Spetzler e Martin, 15 pacientes tinham MAV grau I, 49 grau II, 55 grau III, 41 grau IV, e 10 grau V. MAV com nidus de tamanho pequeno, aferência e eferência únicas foram associados à hemorragia. Hemorragia foi positivamente associada com grau I e negativamente com grau V. A associação entre convulsão e nidus de tamanho grande foi positiva, porém negativa com nidus de tamanho pequeno.PAlAVrAS-cHAVe: malformações arteriovenosas encefálicas, angioarquitetura, apresentação clínica. of AVMs remains incompletely elucidated and its treatment is still a challenge to neurosurgeons. The purpose of this study was to morphologically characterize a series of brain arteriovenous malformations, trying to establish a correlation with their clinical presentation. METHODone hundred and seventy patients with brain AVMs, admitted at the Vascular and endovascular Neurosurgery Unit of Hospital de Base at São José do rio Preto, São Paulo, Brazil, were studied between January, 2001, and January, 2007. Seventy-eight (46%) were male and 92 (54%) female, and age ranged from 1 to 77 years (34.1±15 years) at presentation.This study was approved by the research ethics committee of the São José do rio Preto Medical School (FAMerP).other types of vascular malformations such as dural fistula, carotid-cavernous ...

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Intravascular pressure measurements in feeding pedicles of brain arteriovenous malformations

Cited by 14 publications

References 23 publications

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

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

Recent progress understanding pathophysiology and genesis of brain AVM—a narrative review

Angioarchitecture and clinical presentation of brain arteriovenous malformations

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