With contributions from leading multidisciplinary experts, this book is a comprehensive compendium on state-of-the-art management of intracranial arteriovenous malformations (AVMs) and arteriovenous fistulas (AVF). All major treatment approaches are encompassed including microsurgery, endovascular treatment, and radiosurgery. The text begins with in-depth coverage of cerebrovascular anatomy susceptible to abnormalities, followed by pathogenesis, physiology, hemodynamics, natural history, clinical presentation, and indications for treatment of AVMs and AVFs. Throughout the book, internationally renowned experts provide clinical pearls and insights based on hand-on surgical expertise, case studies, and evidence-based data. Key Highlights Diagnosis and treatment of uncommon congenital syndromes including Wyburn-Mason syndrome and Parkes-Weber syndrome; and autosomal dominant genetic disorders such as Hereditary Hemorrhagic Telangiectasia (Osler-Weber-Rendu syndrome) and Capillary malformation/arteriovenous malformation (CM-AVM) syndrome. More than 300 high quality illustrations plus videos elucidate impacted cerebrovasculature and treatment modalities. The utilization of preoperative and postoperative imaging for AVM evaluation and intraoperative imaging for AVMs and AVFs. Surgical management of lobar AVMs, brain dural arteriovenous fistulas, cerebellar AVMs, basal ganglia, thalamic, and brainstem AVMs. Complications and controversies including hemorrhaging, inoperable malformations, pediatric cases, residual or recurrent AVMs, epilepsy, and seizures. With step-by-step tutorials and classification systems for brain AVMs and fistulas, this is a must-have guide on cerebrovascular malformations. It will benefit trainee and experienced neurosurgeons alike.
This book reviews the natural course of arteriovenous malformation (AVM) disease and the active treatment modalities. These are compared with surgical and neuropsychological results achieved at the Military University Hospital, Prague, Czech Republic. Based on these comparisons, treatment recommendation for AVM is articulated. Furthermore, the long-term efficacy of different treatment is discussed. This book is written by an international group of European authors, and is aimed at neurovascular surgeons and neurosurgical residents.
Highlights: Fluorescein angiography seems to be a valuable alternative to indocyanin green in brain AVM surgery. Fluorescein and ICG might be used together. Bolus injections of fluorescein are well tolerated during brain surgery. Abstract: Brain arteriovenous malformations (AVM) are complex and highly challenging lesions, for which intra-operative indocyanin green fluorescence video angiography is widely used. Fluorescein video angiography (FVA) recently appeared as an alternative technique but the feasibility and usefulness of this technique is yet uncertain. This short series reports our preliminary experience of FVA in intracranial AVM surgery. We retrospectively studied the cases of seven patients who had FVA for an AVM surgery. The primary objective of this study was to assess the utility of FVA as judged by the surgeon. Secondary objectives were the evaluation of the tolerance of bolus injection of fluorescein in the context of cranial surgery, the comparison with ICG and the rate of complete removal. For each of the seven patients, FVA was performed after exposure of the AVM and before the resection; it was visualized directly through the eyepieces of the microscope and helped in the identification of arterial feeders and draining veins. In one case, post-resection FVA allowed the visualization of a residual shunt and the resection was completed. In two cases, ICG and FVA brought comparable information. The resection was complete in all cases, confirmed by post-operative imaging. There was no anaphylactic complication. This preliminary work suggests that FVA is a simple and well tolerated technique, comparable to ICG angiography. Prospective and larger studies are needed to confirm the clinical benefit of this tool.
Clinical outcomes of brain vascular malformation have been greatly improved by advances in microsurgery, endovascular techniques and stereotactic radiosurgery. Radiosurgery has proven to be the least invasive technique and is associated with documented long-term success. The papers in this volume present the experience of leading brain vascular malformation specialists who describe the outcome of radiosurgery for arteriovenous malformations, cavernous malformations and dural arteriovenous fistulas. These reviews expand the knowledge of the role of stereotactic radiosurgery alone or in combination with other treatment modalities. Evidence-based guidelines are included in each section to provide a summary of the current management strategies. This unique publication includes additional data that will further define the long-term benefit and risks of radiosurgery for these often complex vascular disorders and makes valuable reading for neurosurgeons, neurologists and endovascular specialists interested in an excellent summary of more than 30 years of accumulated experience in the management of brain vascular malformations.
Comprehensive, state-of-the-art review of the natural history, treatment, and outcomes of patients with vascular malformations of the brain and spine.
Arteriovenous Malformations: New Insights for the Healthcare Professional: 2011 Edition is a ScholarlyPaper™ that delivers timely, authoritative, and intensively focused information about Arteriovenous Malformations in a compact format. The editors have built Arteriovenous Malformations: New Insights for the Healthcare Professional: 2011 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Arteriovenous Malformations in this eBook to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Arteriovenous Malformations: New Insights for the Healthcare Professional: 2011 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.
Abstract OBJECTIVE Stereotactic radiosurgery makes brain arteriovenous malformations (AVM) more manageable during their microsurgical resection. To better characterize these effects, we compared results of microsurgical resection of radiated (RS) and nonradiated (RS) AVMs to demonstrate that previous radiosurgery facilitates surgery and decreases operative morbidity. METHODS From our series of 344 patients who underwent AVM resections at the University of California, San Francisco (1997–2007), 21 RS patients were matched with 21 RS patients based on pretreatment clinical and AVM characteristics. Matching was blinded to outcomes, which were assessed with the modified Rankin Scale. RESULTS Mean AVM volume was reduced by 78% (P
AVM of the Brain, Clinical Considerations, General and Special Operative Techniques, Surgical Results, Non-operated Cases, Cavernous and Venous Angiomas, Neuro-anesthesia
Offering expert recommendations and selected color illustrations, this guide furnishes readers with state-of-the-art information on the pathophysiology, diagnosis, evaluation, and treatment of AVMs. Offering a multidisciplinary approach, this book spans a wide array of therapeutic options and surgical approaches with step-by-step presentations of each procedure covered in the text.
Purpose: To discuss the safety of ethanol ablation therapy in treating brain arteriovenous malformation uff08bAVMuff09Materials & Methods: Between September 3, 2018 and November 11,2018, a total of 12 patients with bAVM received targeted endovascular ethanol ablation therapy. Results: Ethanol ablation therapy was carried out on 19 arteries in 12 patients. A total of 13 target aneurysms and 6 target arteriovenous fistulae were ablated. Among the 19 target arteriesuff0c 15 were completely ablated by pure ethanol injectionuff0c 2 were cured by ethanol combined with Onxy glue injectionuff0c one was cured by ethanol injection of arteriovenous fistula together with transvenous embolizationuff0c and one was demonstrated mild contrast opacification within the target aneurysm after treatment. Eight of the 12 patients developed different degrees of brain edema.Five of the 8 patients had newly-developed cerebral infarction.Only one patient remained obvious neurological impairment at the time of discharge.Conclusions: For the treatment of bAVM, endovascular ethanol ablation maybe technically feasible and clinically safeuff0c although studies with large sample are still needed to further clarify its effect .
This sequel to Dr. Lawtons best-selling Seven Aneurysms focuses on microsurgical resection techniques for AVMs found in the lobes and deep regions of the brain. It categorizes the techniques into subtypes to simplify the broad spectrum of brain AVMs neurosurgeons may encounter. The book is organized into three sections: The Tenets, which establishes eight steps for AVM resection; The Seven Arteriovenous Malformations, which describes the anatomical terrain and surgical strategies for thirty-two AVM subtypes; and The Selection section, in which Dr. Lawton discusses what he believes to be the keys to successful AVM surgery: good patient selection and best application of multiple treatment modalities. Key Features: Includes more than 700 spectacular full-color illustrations developed exclusively for this book Creates a system for conceptualizing and approaching AVMs Illustrates a stepwise process for AVM resection using strategic battle plans Summarizing the common AVMs encountered in practice, neurosurgeons and neurosurgical residents will find this hybrid atlas-text to be an essential part of their armamentarium.
Guest Editors Rafael J. Tamargo and Judy Huang have focused on “Cranial Arteriovenous Malformations (AVMs) and Dural Arteriovenous Fistulas (DAVFs) in this issue of Neurosurgery Clinics of North America. Articles in this issue include: Arteriovenous Malformations: Epidemiology and Clinical Presentation; Dural Arteriovenous Fistulas: Epidemiology and Clinical Presentation; Historical Perspective of Treatments of Arteriovenous Malformations and Dural Arteriovenous Fistulas; Imaging of Arteriovenous Malformations and Dural Arteriovenous Fistulas; Classification Schemes for Arteriovenous Malformations; Classification Schemes for Dural Arteriovenous Fistulas; Acute Management of Ruptured Arteriovenous Malformations and Dural Arteriovenous Fistulas; Selection of Treatment Modalities or Observation of Arteriovenous Malformations; Selection of Treatment Modalities or Observation of Dural Arteriovenous Malformations; Surgical Treatment of Cranial Arteriovenous Malformations and Dural Arteriovenous Fistulas; Anesthesia Considerations and Intraoperative Monitoring During Surgery for Arteriovenous Malformations and Dural Arteriovenous Fistulas; Stereotactic Radiosurgery of Cranial Arteriovenous Malformations and Dural Arteriovenous Fistulas; Endovascular Treatment of Cranial Arteriovenous Malformations and Dural Arteriovenous Malformations; Occlusive Hyperemia Versus Normal Perfusion Pressure Breakthrough after Treatment of Cranial Arteriovenous Malformations; Vein of Galen Malformations: Epidemiology, Clinical Presentation, and Management; Carotid Cavernous Fistulas: Epidemiology, Clinical Presentation, and Management.
Arteriovenous and Cavernous Malformations, Volume 143, is the latest addition in the ongoing HCN series, an evidence-based compendium which addresses both the scientific and clinical aspects of this unique disease process. The volume covers didactic aspects, such as the epidemiology, etiology, and diagnosis of AVMs, while also providing expert clinical information on the management and treatment of these lesions. In addition, it provides coverage of modern-day advances in the genetics of cavernous malformations, as well as discussion regarding future open research questions. Readers from the laboratory bench to the bedside can expect a broad, yet objective, review of this pathology, with updates from the latest scientific literature and data supporting current practices. Offers an evidence-based focus with coverage of both the scientific and clinical aspects of cavernous malformations Addresses epidemiology, etiology, diagnosis, and genetics Contains clinical insights regarding indications for surgery, surgical techniques, outcomes, and prognostic factors drawn from the authors' extensive experiences Edited work with chapters authored by leaders in the field from around the globe – the broadest, most expert coverage available
Arteriovenous malformations (AVM) and arteriovenous fistulas (AVF) differ from all other pathology affecting the central nervous system by their high-flow arteriovenous shunts. Permanent occlusion of these shunts is the essence and the challenge of therapy. Endovascular therapy and radiosurgery became accepted alternatives or adjuncts to surgery. In many instances the choice of the primary therapeutic modality is not clear and arguments can be found for several options. However, microsurgery, endovascular therapy and radiosurgery differ very much with regard to invasiveness, length of stay at the hospital but also residual risk after therapy. The emerging treatment concepts are the object of this book. The result is a unique structured presentation of AVM and AVF therapy.
Through the combination of the latest imaging modalities and microdevice delivery, interventional neuroradiologic techniques are currently revolutionizing the therapy for many of the most common neurological and neurosurgical disorders. Crossing the boundaries of classically delineated medical and surgical specialties including neurosurgery, neuroradiology, and neurology, interventional neuroradiology uses advanced neuroimaging combined with endovascular techniques to guide catheters and devices through blood vessels. These procedures can treat diseases involving structures of the head, neck, and central nervous system. These advances now provide noninvasive treatment for many disorders that were previously treated only with open surgical techniques, and make treatments possible for many patients—who until recently would have had no acceptable therapeutic options. Interventional Neuroradiology discusses CT, MR, and ultrasonographic evaluation of cerebrovascular disease, focusing on current neuroimaging evaluation of disorders. It emphasizes the integration of current neuroimaging information into decision-making and performance practices for neuroendovascular procedures. The book describes clinical techniques and includes the most current technical modifications for the varying devices in use today. Filled with scientifically concise illustrations, the text depicts pertinent neuroanatomy, imaging, and neuroendovascular techniques. Written by a panel of today's leading experts in the field of interventional neuroradiology, this volume demonstrates the potential of these lifesaving techniques.
This book describes the pathoanatomical, pathophysiological, and imaging features of vascular malformations and aneurysms of the brain and the modern, minimally invasive endovascular methods and techniques employed in their treatment. All chapters in the second revised edition of this book have been thoroughly updated. Readers will find this clearly organized book is richly illustrated with numerous informative CT, MR and DSA images, including high-end 7-Tesla MR images.