Recurrence of "cured" dural arteriovenous fistulas after Onyx embolization.

Endovascular embolization with Onyx has been increasingly used to treat intracranial and spinal dural arteriovenous fistulas (DAVFs). Several case series have been published in recent years reporting high DAVF cure rates with this technique. Although it is seldom reported, DAVF recurrence may occur despite initial "cure.

Endovascular management of spinal dural arteriovenous fistulas. A review.

Object: Spinal dural arteriovenous fistulas (DAVFs) are the most common spinal vascular malformations and can be a significant cause of myelopathy, yet remain inefficiently diagnosed lesions. Over the last several decades, the treatment of spinal DAVFs has improved tremendously due to improvements in neuroimaging, microsurgical, and endovascular techniques. The aim of this paper was to review the existing literature regarding the clinical characteristics, classification, and endovascular management of spinal DAVFs.

Internal carotid artery aneurysms occurring at the origin of fetal variant posterior cerebral arteries: surgical and endovascular experience.

Objective: A fetal variant posterior cerebral artery (fetal PCA) is an embryological remnant in which the PCA is primarily supplied via the anterior cerebral circulation. Internal carotid artery (ICA) aneurysms originating from the takeoff of fetal PCA vessels deserve special attention before surgical or endovascular obliteration because of a greater potential for ischemic injury. We present the first series of ICA-posterior communicating artery (PComA) aneurysms originating at the takeoff of fetal PCA vessels that were treated by surgical or endovascular intervention.

Novel use of an endovascular embolectomy device for retrograde suction decompression-assisted clip ligation of a large paraclinoid aneurysm: technical case report.

Objective: Several different methodologies for proximal occlusion and retrograde suction decompression of large paraclinoid aneurysms have been reported previously. In this article, we describe the novel use of an endovascular embolectomy device (F.A.

A novel technique and new grading scale for the embolization of cerebral vascular malformations.

Objective: Effective transarterial embolization of a dural arteriovenous fistula or pial arteriovenous malformation (AVM) requires penetration of a durable occlusive agent into the fistula or AVM nidus. Cyanoacrylate glue often cannot traverse the tortuous vessels that typically supply such malformations, leading to proximal occlusion and recruitment of collateral flow. Other embolic agents, such as polyvinyl alcohol particles, achieve better penetration, but their effects are short lived, often leading to recanalization.

Percutaneous spinal interventions.

Interventional neuroradiology procedures of the spine are being performed with increasing frequency. These therapies complement and, in some cases, replace more conventional operations of the vertebral column and its contents. This article surveys the background, present application, and future horizons of several minimally invasive spinal interventions, including vertebroplasty and kyphoplasty, microcatheterization of the cervical epidural space via lumbar puncture for drug delivery, percutaneous intraspinal navigation, and percutaneous spinal fixation.

Use of a screw-syringe injector for cement delivery during kyphoplasty: technical report.

Objective: Percutaneous kyphoplasty is postulated to have several advantages over percutaneous vertebroplasty for the treatment of vertebral compression fractures and is gaining increased popularity. However, cement delivery with the KyphX kit (Kyphon, Inc., Santa Clara, CA), the only commercially available device for percutaneous kyphoplasty, is relatively problematic.

Traumatic vascular injuries and their management.

Traumatic vascular injury to the intracranial and extracranial circulation can be sequelae of blunt, penetrating, or iatrogenic insults to the head, face, or neck. Treatment options include conservative medical management, or more invasive surgical or endovascular therapy. The appropriate treatment depends on the risk-benefit ratio of each option considering the natural history of each.

Covered stent-graft repair of the brachiocephalic arteries: technical note.

Objective: The use of a covered stent-graft to repair disruptions of the cervical carotid and vertebral arteries is described. This device maintains vessel patency while effectively excluding pseudoaneurysms, arteriovenous fistulae, and other breaches in the integrity of the arterial wall.

Methods: Patient 1 bled from a large rent in the proximal common carotid artery as a result of tumor invasion.