Vertebral artery transection with pseudoaneurysm and arteriovenous fistula requiring antegrade and retrograde embolization

Karatela, Maham; Weissler, E. Hope; Cox, Margueritte; Williams, Zachary

doi:10.1016/j.jvscit.2022.01.009

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…The shift towards these methods over traditional open surgeries may be attributed to their minimally invasive nature, potential for quicker recovery, and reduced risk of complications. As highlighted by Karatela et al [20] and several others, endovascular approaches frequently result in positive outcomes with reduced morbidity compared to more invasive methods.…”

Section: Discussionmentioning

confidence: 95%

“…After the first screening, 48 articles were selected and 425 were excluded. In the last screened series of articles, 11 were selected [15,[19][20][21][22][23][24][25][26][27][28]. Each of these 11 carefully assessed articles successfully met the predetermined inclusion criteria and was therefore integrated into the review, as delineated in (Tables 1-2).…”

Section: Literature Reviewmentioning

confidence: 99%

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Multiple Myeloma Treatment Challenges: A Case Report of Vertebral Artery Pseudoaneurysm Complicating Occipitocervical Arthrodesis and a Review of the Literature

Reyes Soto,

Ovalle Torres,

Perez Terrazas

et al. 2023

Cureus

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Multiple myeloma is a hematological neoplasm that frequently affects the spinal column. Less than a fifth of this vertebral involvement corresponds to the cervical spine and cranio-cervical junction. When there is instability or neurological involvement due to compression or deformity, approaches for anterior decompression and occipitocervical stabilization are required. The correct managment of vertebral artery aneurysm associated with occipitocervical arthrodesis requires extensive knowledge of anatomy and pathology. We present a case of a vertebral pseudoaneurysm that occurred late after the resection of a C1-C2 vertebral body multiple myeloma lesion managed with endonasal endoscopic approach and posterior occipitocervical arthrodesis as well as a systematic review of the related literature. The patient recovered well, without major neurological deficits.

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Section: Discussionmentioning

confidence: 95%

Section: Literature Reviewmentioning

confidence: 99%

Multiple Myeloma Treatment Challenges: A Case Report of Vertebral Artery Pseudoaneurysm Complicating Occipitocervical Arthrodesis and a Review of the Literature

Reyes Soto,

Ovalle Torres,

Perez Terrazas

et al. 2023

Cureus

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“…Для снижения риска развития инсульта перед эмболизацией поврежденной ПА необходимо проведение ее контралатеральной ангиографии (из здоровой ПА). При наличии явного ретроградного (коллатерального) кровотока данная процедура относительно безопасна, кроме того, в ряде случаев возможно ее выполнение через контралатеральный доступ [24]. С этой же целью перед открытым лигированием ПА необходимо проводить оценку данных КТА, а при эндоваскулярной эмболизации -выполнять прямую ангиографию всех 4 артериальных бассейнов головного мозга для выявления гипоплазий / аплазий контралатеральной ПА, задней соединительной артерии, обеспечивающих коллатеральный кровоток в ВББ [25].…”

Section: D Reconstruction Of the Patient's Appearance After Open Surg...unclassified

“…Если проведение вышеуказанных манипуляций затруднено, а по данным инструментальных методов диагностики коллатеральный кровоток не нарушен, возможно тампонирование V2-сегмента ПА в позвоночных отверстиях поперечных отростков шейных позвонков костным воском [9]. В ряде случаев рассматривают более сложные реваскуляризиру ющие хирургические вмешательства, описанные выше [24]. Иногда открытое лигирование / тампонирование может оказаться невозможным по причине множественных повреждений или недоступности целевого участка ПА.…”

Section: D Reconstruction Of the Patient's Appearance After Open Surg...unclassified

Traumatic injury of vertebral artery complicated by formation of a giant pseudoaneurysm of the V3 segment (clinical observation and literature review)

Ayrapetyan,

Gromov,

Papoyan

et al. 2024

Nejrohirurgiâ (Mosk.)

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Traumatic vertebral artery injury (TVAI) is a rare but severe pathology which can be associated both with penetrating injury of the neck and blunt or unclassified injury. Injury of the vertebral artery, especially due to gunshot or knife wounds, causes severe condition of the patients, development of a wide spectrum of complications including life-threatening, high rates of disabilities and mortality.There is no consensus on the treatment tactics for this pathology. Open surgery as the first stage of surgical intervention can be used in a limited number of cases. X-ray endovascular techniques of TVAI treatment are considered to be preferable.We present a clinical case of a 27‑year-old patient with TVAI caused by a penetrating gunshot wound of the neck and complicated by formation of a giant pseudoaneurysm of the V3 segment of the vertebral artery. Two-stage combination treatment of TVAI was performed using endovascular and open surgical techniques.Descriptions of TVAI cases are rare, and further accumulation and analysis of corresponding data and proposals on treatment of the patients with TVAI will help to formulate precise algorithms of doctors’ actions and optimize treatment tactics.

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The Rationale Behind Transcirculation Neuroendovascular Interventions: Literature Review Through a Case-Series Approach

Colasurdo

Edhayan

Taweel

et al. 2022

Operative Neurosurgery

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BACKGROUND:With the development of advanced endovascular techniques and materials, neurointerventionalists can perform challenging and complex cases that were previously difficult to perform. Transcirculation approaches could be a useful tool used in complicated cases, providing access to the target vessel, through the contralateral or opposite circulation, when anterograde access is difficult or nonachievable.OBJECTIVE:To retrospectively review cerebrovascular interventions performed through a transcirculation approach performed by staff at our Institution.METHODS:English-language studies, published until August 2022, reporting transcirculation interventions in the cerebrovascular circulation were retrospectively collected. Type of intervention, number of cases, rationale, and complications were analyzed. Furthermore, similar cases performed by staff currently at our institution were also reviewed and described.RESULTS:Including our cases, a total of 273 transcirculation treatment approaches have been reported. Intracranial aneurysm embolization, stroke thrombectomies, intra-arterial ophthalmic chemotherapy, arteriovenous malformationss, arteriovenous fistulas embolizations, and intracranial angioplasty and stenting are common indications. Reason for using a retrograde approach were stent/balloon–assisted coiling of wide neck aneurysm in 116 cases, difficult angulation of branch in 91 cases, occlusion of parent vessel in 55 cases, and bailout/other in 11 cases.CONCLUSION:Transcirculation approaches can be considered for cases where conventional anterograde treatment options are not feasible or as a bailout strategy in failed or complicated treatment attempts. They represent a strategy to consider when facing challenging cases, and if performed by experienced and dedicated neurointerventionalists, they can represent a safe alternative.

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Vertebral artery transection with pseudoaneurysm and arteriovenous fistula requiring antegrade and retrograde embolization

Cited by 3 publications

References 23 publications

Multiple Myeloma Treatment Challenges: A Case Report of Vertebral Artery Pseudoaneurysm Complicating Occipitocervical Arthrodesis and a Review of the Literature

Multiple Myeloma Treatment Challenges: A Case Report of Vertebral Artery Pseudoaneurysm Complicating Occipitocervical Arthrodesis and a Review of the Literature

Traumatic injury of vertebral artery complicated by formation of a giant pseudoaneurysm of the V3 segment (clinical observation and literature review)

The Rationale Behind Transcirculation Neuroendovascular Interventions: Literature Review Through a Case-Series Approach

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