Progressive regression of intracranial arteriovenous malformations after Onyx embolization

Kocur, Damian; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Doleżych, Hanna; Baron, Jan; Kwiek, S

doi:10.1016/j.pjnns.2017.03.005

Cited by 3 publications

(6 citation statements)

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“…Physiologic high-intensity activity is seen in the lacrimal, parotid, and submandibular glands (22). The precise mechanism of uptake remains uncertain but probably reflects a combination of nonspecific excretion and PSMA expression in these tissues.…”

Section: Primary Staging Of Prostate Cancermentioning

confidence: 99%

Prostate-specific Membrane Antigen PET: Clinical Utility in Prostate Cancer, Normal Patterns, Pearls, and Pitfalls

et al. 2018

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Prostate-specific membrane antigen (PSMA) is a transmembrane glycoprotein that is overexpressed in prostate cancer. Radiolabeled small molecules that bind with high affinity to its active extracellular center have emerged as a potential new diagnostic standard of reference for prostate cancer, resulting in images with extraordinary tumor-to-background contrast. Currently, gallium 68 (Ga)-PSMA-11 (or HBED-PSMA) is the most widely used radiotracer for PSMA positron emission tomography (PET)/computed tomography (CT) or PSMA PET/magnetic resonance (MR) imaging. Evolving evidence demonstrates superior sensitivity and specificity of PSMA PET compared to conventional imaging, with frequent identification of subcentimeter prostate cancer lesions. PSMA PET is effective for imaging disease in the prostate, lymph nodes, soft tissue, and bone in a "one-stop-shop" examination. There is emerging evidence for its clinical value in staging of high-risk primary prostate cancer and localization of disease in biochemical recurrence. The high sensitivity provided by PSMA PET, with frequent identification of small-volume disease, is redefining patterns of disease spread compared with those seen at conventional imaging. In metastatic castration-resistant prostate cancer, PSMA PET is frequently used for theranostic selection (eg, lutetium 177-PSMA radionuclide therapy), but its potential use for therapy monitoring is still under debate. However, evidence on its proper use to improve patient-related outcomes, particularly in the setting of early biochemical recurrence and targeted treatment of oligometastatic disease, is still missing. Despite the term prostate specific, PSMA functions as a folate hydrolase and is expressed in a range of normal tissues and in other benign and malignant processes. Knowledge of its physiologic distribution and other causes of uptake is essential to minimize false-positive imaging findings. RSNA, 2018.

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Section: Primary Staging Of Prostate Cancermentioning

confidence: 99%

Prostate-specific Membrane Antigen PET: Clinical Utility in Prostate Cancer, Normal Patterns, Pearls, and Pitfalls

et al. 2018

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“…Limited number and stenosis of the draining veins also had an important effect in inducing thrombosis. Also, partial embolization may decrease the angiogenic factors affecting the endothelial cells followed by a reduction in size and obliteration [12,14,23,16,[1][2][3]9,11,20,24,28]. Mangia co et al [12].…”

Section: Discussionmentioning

confidence: 99%

“…Reported one case occluded after 70% occlusion of the nidus in 2 sessions. Kocur et al [9].and Torrico et al [24]. Each reported 2 cases after being embolized with onyx.…”

Section: Discussionmentioning

confidence: 99%

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Angiographic predictors of spontaneous obliteration of transarterial partially embolized brain arteriovenous malformations

2022

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Background Spontaneous obliteration of cerebral arteriovenous malformations is uncommon but could occur after partial embolization. Methods A retrospective study of 140 patients that underwent embolization for cerebral AVMs from 2005 to August 2019 using liquid embolic agents. The angiographic outcome of patients was classified as regard complete embolization, partial embolization, and complete obliteration after partial embolization. The parameters studied included size, location, number of arterial feeders, number of draining veins, rupture status, embolic agent, and patient factors as well. Results The study patients included 74 (53%) females and 66 (47%) males. Their age ranged from 7 to 43 years old. One hundred and eight patients (77%) presented with hemorrhage. The AVM grades were grade II in 57 (40.7%) patients and grade III in 56 (39.3%) patients. Sixty-one (43.57%) patients were treated by n-Butyl Cyanoacrylate and 71 (50.71%) patients were treated with Onyx, and both materials were used together in 8 cases. Follow-up angiography was done from 6 to 36 months after embolization. The rate of complete occlusion in all patients was 61.43% (86 patients). There were three groups of patients, the first group had complete occlusion of the nidus at the time of embolization and included 68 (48.57%) patients. The second group had partial embolization with partial occlusion of the nidus 54 patients (38.57%). The 3rd group included 18 patients (12.85%) with complete nidal occlusion on follow up after partial embolization. The delay in the venous drainage of the AVM to the late arterial phase or early venous phase with flow stasis was a significant predictor of future obliteration on follow up after partial embolization. Other significant parameters that were associated with the progressive disappearance of the AVM nidus on follow up after partial embolization are presentation with hemorrhage, AVMs size less than 3 cm, the presence of single draining or double draining veins, superficial venous drainage, and one or 2 arterial feeders. Conclusion Spontaneous closure of intracranial arteriovenous malformations after partial embolization may be encountered in cases of stasis of flow during embolization procedure with a delay of the venous drainage. A long-term follow-up of more cases over many years is required to confirm the validity of this conclusion.

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“…some studies indicated that partial embolization may carry the risk of increased hemorrhage [6,10,16,23,26]. Many previous studies reported the disappearance of AVM nidus after partial embolization or even after surgery [1][2][3]9,11,16,20,23,24,28].…”

Section: Introductionmentioning

confidence: 99%

Angiographic Predictors of Spontaneous Obliteration of Transarterial Partially Embolized Brain Arteriovenous Malformations.

Sultan

Hassan²,

Metwaly³

2021

Preprint

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Background: spontaneous obliteration of cerebral arteriovenous malformations is uncommon but could occur after partial embolization. Materials and methods:A retrospective study of 140 patients that underwent embolization for cerebral AVMs from 2005 to August 2019 using liquid embolic agents. The angiographic outcome of patients was classified as regard complete embolization, partial embolization, and complete obliteration after partial embolization. The parameters studied included size, location, number of arterial feeders, number of draining veins, rupture status, embolic agent, and patient factors as well.Results: The study patients included 74 (53%) females and 66 (47%) males. Their age ranged from 7 to 43 years old. One hundred and eight patients (77%) presented with hemorrhage. The AVM grades were grade II in 57 (40.7%) patients and grade III in 56 (39.3%) patients. Sixty-one (43.57%) patients were treated by n-Butyl Cyanoacrylate and 71(50.71%) patients were treated with Onyx, and both materials were used together in 8 cases. Follow-up angiography was done from 6 to 36 months after embolization. The rate of complete occlusion in all patients was 61.43% (86 patients). There were three groups of patients, the first group had complete occlusion of the nidus at the time of embolization and included 68 (48.57%) patients. The second group had partial embolization with partial occlusion of the nidus 54 patients (38.57%). The 3rd group included 18 patients (12.85%) with complete nidal occlusion on follow up after partial embolization. The delay in the venous drainage of the AVM to the late arterial phase or early venous phase with flow stasis was a significant predictor of future obliteration on follow up after partial embolization. Other significant parameters that were associated with the progressive disappearance of the AVM nidus on follow up after partial embolization are presentation with hemorrhage, AVMs size less than 3 cm, the presence of single draining or double draining veins, superficial venous drainage, and one or 2 arterial feeders.Conclusion: spontaneous closure of intracranial arteriovenous malformations after partial embolization may be encountered in cases of stasis of flow during embolization procedure with a delay of the venous drainage. A long-term follow-up of more cases over many years is required to confirm the validity of this conclusion.

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Progressive regression of intracranial arteriovenous malformations after Onyx embolization

Cited by 3 publications

References 20 publications

Prostate-specific Membrane Antigen PET: Clinical Utility in Prostate Cancer, Normal Patterns, Pearls, and Pitfalls

Prostate-specific Membrane Antigen PET: Clinical Utility in Prostate Cancer, Normal Patterns, Pearls, and Pitfalls

Angiographic predictors of spontaneous obliteration of transarterial partially embolized brain arteriovenous malformations

Angiographic Predictors of Spontaneous Obliteration of Transarterial Partially Embolized Brain Arteriovenous Malformations.

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