• Title/Summary/Keyword: Arteriovenous malformation

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Pulmonary Arteriovenous Fistula - One Case Report - (폐동정맥루 1례 보고)

  • 성시찬
    • Journal of Chest Surgery
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    • v.21 no.4
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    • pp.711-715
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    • 1988
  • Pulmonary arteriovenous fistula is a congenital vascular malformation originated from abnormalities of capillary development. Fistulas may develop only in the lung or may be associated with similar abnormalities of the skin, mucous membrane, and the other organs. It may occur with hereditary hemorrhagic telangietasia[Rendu-Osier-Weber syndrome]. Recently we have experienced a case of the pulmonary arteriovenous fistula associated with Schwannoma in 20 year old male man. Tennis ball sized bright reddish mass which was composed of variable sized vascular channels filled with blood clots was located in the just subpleural portion of left lower lobe. Left lower lobectomy was done. Microscopic findings showed variable sized numerous blood vessels embedding in the parenchyma. There was a thumb-tip sized brown nodular mass which was turned out to be Schwannoma at the left 7th thoracic paravertebral area.

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Cervicomedullary Junction AVM Presenting Recurrent Intraventricular Hemorrhage - A Case Report - (재발성 뇌실내출혈을 일으킨 경연수접합부 동정맥기형 - 증례보고 -)

  • Lee, Sang Weon;Choi, Chang Hwa;Cha, Seung Heon;Park, Dong June;Song, Geun Sung;Lee, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.30 no.6
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    • pp.781-785
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    • 2001
  • Cervicomedullary junction arteriovenous malformation(AVM) is extremely rare. The authors present a case of a cervicomedullary junction AVM in a 31-year-old woman presenting with recurrent intraventricular hemorrhage (IVH). Magnetic resonance imaging revealed the AVM(of a size of approximately $2{\times}2.5{\times}4cm$) extending from a lower medulla to C2-3 level. Vertebral angiography demonstrated a tightly coiled vascular mass with multiple feeders (radiculomedullary arteries) and irregular-shaped aneurysm at distal part of feeder originating at right C-1 level. The patient underwent superselective embolization of upper nidus and the aneurysm. The pertinent literature is reviewed, and diagnostic and therapeutic implications are discussed.

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Surgery of Parasplenial Arteriovenous Malformation with Preservation of Vision - A Case Report - (부뇌량팽대 동정맥 기형의 수술에서 시야의 보존 - 증례보고 -)

  • Joo, Jin Yang;Ahn, Jung Yong
    • Journal of Korean Neurosurgical Society
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    • v.29 no.6
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    • pp.815-821
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    • 2000
  • Parasplenial arteriovenous malformations(AVMs) are rare vascular malformations which have distinct clinical and anatomical features. They are situated at the confluence of the hippocampus, isthmus of the cingulate gyrus and the gyrus occipitotemporalis medialis. These lesions are anterior to the calcarine sulcus and their apex extends towards the medial surface of the trigonum. Posterolaterally, these lesions are in close proximity to the visual cortex and optic radiation. The objectives in the surgery of parasplenial AVMs are complete resection of the lesions and preservation of vision. These objectives must be achieved with comprehensive understanding of the following anatomical features :1) the deep central location of the lesions within eloquent brain tissue ; 2) the lack of cortical representation of the AVMs that requires retraction of visual cortex ; 3) deep arterial supply ; 4) deep venous drainage ; 5) juxtaposition to the choroid plexus with which arterial supply and venous drainage are shared. A 16-year-old female student presented with intraventricular hemorrhage from a right parasplenial-subtrigonal AVM. The lesion, fed by posterior cerebral artery and drained into the vein of Galen, was successfully treated by the inter-hemispheric parietooccipital approach. To avoid visual field defect a small incision was made on precuneus anterior to the calcarine sulcus. In this report, the authors describe a surgical approach with special consideration on preservation of visual field.

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Transcatheter Embolization of Giant Pulmonary Arteriovenous Malformation with an Amplatzer Vascular Plug II

  • Kong, Joon Hyuk;Oh, Tae Yun;Kim, Jung Tae;Baek, Kang Seok;Chang, Woon-Ha
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.326-329
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    • 2012
  • Pulmonary arteriovenous malformation (PAVM) is a rare anomalous direct communication between the pulmonary artery and vein with a considerable risk of serious complications such as cerebral thromboembolism or abscess and pulmonary hemorrhage. Although the past, surgical resection such as lobectomy was mostly used to treat PAVM, the recent development of endovascular treatment has made it a primary consideration to perform transcatheter embolization using coils or detachable balloons. We report a case of successful transcatheter embolization of giant PAVM with the second generation Amplatzer vascular plug II as a new self-expanding device.

Stereotactic Radiosurgery of 26 Intracranial Arteriovenous Malformations with Linear Accelerator (뇌동정맥기형 26예의 선형가속기를 이용한 뇌정위다방향 단일방사선치료)

  • Yoon Sei Chul;Suh Tae Suck;Jang Hong Seok;Choi Kyu Ho;Kim Moon Chan;Shinn Kyung Sub;Bahk Yong Whee
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.21-26
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    • 1992
  • From July 1988 through November 1991,26 patients with inoperable arteriovenous malformations were treated with 6 MV linear accelerator at the Kangnam St. Mary's Hospital, Catholic University Medical College. There were 5 females and 21 males with median age of 29 years (range: $6\~63$ years) and median follow up times of 15 months (range: $4\~40$ months). The arteriovenous malformation volumes treated ranged from 1 cm diameter to 3.5 cm rectangular size. The prescribed doses at the isocenter varied from 15 to 30 Gy and were given as a single fraction. To date, all patients performed follow-up not only clinically but also through CT or angiography based radiologic modalities every 6 month. A complete obliteration was achieved in 6 ($23\%$) and partial obliteration in 8 ($31\%$) and no change in 1 ($4\%$). We observed 14 ($54\%$) responsiveness of arteriovenous malformations after radiosurgery by 2 years afterward. Whereas, the decision of the remaining 11 ($42\%$) patients was considered too early to expect the therapeutic response following radiosurgery. No complications through treatment related were observed, yet. Our initial outcome in these first 26 patients with arteriovenous malformations is recommended further follow-up.

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Treatment of Multiple Pulmonary Arteriovenous Fistulas with Therapeutic Embolization in Osler-Rendu-Weber Syndrome (Osler-Rendu-Weber 증후군 환자에서 색전요법을 이용한 다발성 폐동정맥루 치험 1예)

  • Kim, Jae-Hag;Choi, Taek-Hee;Nam, Seung-Mo;Chang, Jae-Jin;Park, Yeon-Hee;Hur, Nam-Hyun;Choe, Du-Hwan;Lee, Byung-Hee;Kim, You-Cheoul;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.914-921
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    • 1997
  • Hereditary hemorrhagic telangiectasia(Osler-Rendu-Weber Syndrome) is characterized by telangiectasia of the skin and mucous membranes and intermittent bleeding from vascular abnormalities. About 20% of patients with this syndrome have pulmonary arteriovenous fistulas. Pulmonary arteriovenous fistula is uncommon malformation which has an abnormal connection between the pulmonary capillary bed, in which venous blood in the pulmonary artery is shunted through the fistula into the pulmonary vein without exposure to alveolar oxygen and result in unoxygenated, desaturated systemic arterial blood, polycythemia, cyanosis and clubbing. Death often results from cerebral abscess and rupture of the malformation with massive hemorrhage. Therapeutic intervention is recommended for all symptomatic patients because of the risk of those serious complications. Treatment options include surgery and transcatheter obliteration with steel coils or detachable balloons. Therapeutic embolization has the advantages that multiple bilateral pulmonary arteriovenous fistulas can be occluded and also that the procedure can be repeated if necessary. Recently we experienced a case of the multiple bilateral pulmonary arteriovenous fistulas associated with telangiectatic change of hepatic artery and multiple angiodysplasia on the gastric mucosa in 41 years old female patient who had mild dyspnea of exertion(NYHA class II). clubbing finger, severe iron deficiency anemia. She was treated with embolization technique using steel coils and iron replacement. After the therapeutic embolization. significant improvement of dyspnea of exertion with disappearance of multiple pulmonary nodule on follow-up simple chest x-ray was noted. During the subsequent six months follow-up period, she had the improvement of symptoms and iron deficiency anemia.

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Treatment of Scalp Arteriovenous Malformation

  • Jung, Sung-Hoon;Yim, Man-Bin;Lee, Chang-Young;Song, Dal-Won;Kim, Il-Man;Son, Eun-Ik
    • Journal of Korean Neurosurgical Society
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    • v.38 no.4
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    • pp.269-272
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    • 2005
  • Objective : The object of this study is to present the treatment experience of the 6cases of scalp arteriovenous malformations[AVMs] focus on treatment strategy. Methods : Six patients with scalp AVM were treated during past 12years. We analysis the clinical characteristics of the lesions, treatment methods and management outcomes. Results : The lesions were located on temporal in 2patients, parietal in 2patients, frontal and occipital area in each one. Four of six patients had a trauma history on scalp. The presenting symptoms were progressive enlarged pulsating mass with or without bruit. Four of the six lesions had the large fistula in the lesion. Two patients were treated with surgical resection alone, three patients with proximal feeding artery balloon[s] occlusion followed by surgical resection, and one patient with coil embolization through trans-venous route alone. We obtained good results in all patients. Conclusion : Most of scalp AVM can be completely cured by Judicious selection and a combination of treatment modalities, i.e., surgery only, or embolization only, or embolization plus surgical therapy. Although embolization became a primary therapy for this sort of scalp AVM recently, the selection of treatment modality should be chose based on the size, angioarchitecture, and clinical presentations of the lesion.

Factors Related to the Success of Gamma Knife Radiosurgery for Arteriovenous Malformations (뇌동정맥기형에 대한 감마나이프 방사선수술시 치료성적에 영향을 주는 인자들)

  • Chang, Jong Hee;Park, Yong Gou;Choi, Jae Young;Chang, Jin Woo;Chung, Sang Sup
    • Journal of Korean Neurosurgical Society
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    • v.30 no.12
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    • pp.1406-1416
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    • 2001
  • Objective : The goal of this study was to evaluate the effect of Gamma Knife radiosurgery(GKS) on cerebral arteriovenous malformation(AVM) and the factors associated with complete occlusion. Patients and Methods : A total of 369 radiosurgical procedures for 336 patients with cerebral AVMs were performed between December 1988 and June 2001. Three hundreds and twenty-four cases of 293 patients who were treated with GKS procedures from May 1992 to December 2000 were analyzed. Various clinical and radiologic parameters were evaluated. Results : The total obliteration rate for the cases with satisfactory radiological follow-up(more than 2 years) after GKS was 79.3%. In multivariate analysis, maximal diameter, angiographic form of AVM nidus, and number of draining veins significantly influenced the result of radiosurgery. In addition, marginal radiation dose, Spetzler-Martin grade, and flow pattern of AVM nidi also partly influenced the radiosurgical outcome. Conclusion : GKS on cerebral AVM is considered as an effective treatment modality. The risk of hemorrhage seems to decrease within the latency interval between GKS and complete occlusion of nidus. Along with the size, topography, or radiosurgical parameters of AVMs, it is necessary to consider the angioarchitectural and hemodynamic aspects to select proper candidates for radiosurgery.

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Comparison of Single- and Multi-Echo Susceptibility-Weighted Imaging in Detecting Cerebral Arteriovenous Shunts: A Preliminary Study (뇌동정맥단락 진단에서의 단일 에코 자화율 강조영상과 다중 에코 자화율 강조영상의 비교: 예비 연구)

  • Seung Wan Han;Jae Ho Shin;Yon Kwon Ihn;Seung Ho Yang;Jae Hoon Sung
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.226-239
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    • 2023
  • Purpose To compare the sensitivities of T2-weighted image (T2WI) and susceptibility-weighted imaging (SWI) in detecting cerebral arteriovenous fistula (AVF), cerebral arteriovenous malformation (AVM), and carotid-cavernous sinus fistula (CCF), and to qualitatively evaluate single-echo SWI (s-SWI) and multi-echo SWI (m-SWI) in characterizing vascular lesions. Materials and Methods From January 2016 to December 2021, cerebral angiography-proven lesions were recruited. The sensitivities of T2WI and SWI in detecting vascular lesions were compared using McNemar's test. Qualitative evaluations of s-SWI and m-SWI were categorized to be of poor, average, or good quality and compared using Fisher's exact test. Results A total of 24 patients (mean age: 61 years, 12 female, and 12 male) were enrolled. Twenty patients underwent s-SWI or m-SWI, and four patients underwent both. AVF, AVM, and CCF were diagnosed in 10, 11, and 3 patients, respectively. SWI demonstrated higher sensitivity compared to that of T2WI (82.1% vs. 53.6%, p = 0.013). m-SWI showed better image quality compared to that of s-SWI (good quality, 83.3% vs. 25.0%, p = 0.009). Conclusion SWI demonstrated a higher sensitivity for detecting cerebral arteriovenous shunts compared to that of T2WI. m-SWI exhibited better image quality compared to that of s-SWI in characterizing vascular lesions.