The efficacy of postoperative middle meningeal artery embolization on chronic subdural hematoma - A multicentered randomized controlled trial.

Background: Middle meningeal artery (MMA) embolization has recently emerged as a potential treatment for chronic subdural hematoma (cSDH). Numerous retrospective studies have suggested that it can potentially reduce the risk of hematoma recurrence following surgical evacuation. We have conducted a randomized controlled trial to investigate the effectiveness of postoperative MMA embolization in reducing recurrence rate, residual hematoma thickness as well as improving functional outcome.

Preoperative angioembolisation of a mediastinal accessory ectopic spleen: A case report and review of the literature.

A 50-year-old male presented to our institution for embolization of an incidentally detected mediastinal mass prior to surgical resection. The patient had undergone extensive pre-procedural imaging as well as bronchoscopy and mediastinoscopy. Ultimately, resection was required for a definitive diagnosis of congenital ectopic mediastinal accessory spleen.

The Woven EndoBridge Device for the Treatment of Intracranial Aneurysms: Initial Clinical Experience within an Australian Population.

Purpose: Advances in endovascular technology have expanded the treatment options for intracranial aneurysms. Intrasaccular flow diversion is a relatively new technique that aims to disrupt blood inflow at the neck of the aneurysm, hence promoting intrasaccular thrombosis. The Woven EndoBridge device (WEB; MicroVention, Aliso Viejo, CA, USA) is an US Food and Drug Administration approved intrasaccular flow diverter for wide-necked aneurysms.

Image-guided spinal injection for pain management.

Radiculopathy and spinal pain are debilitating conditions affecting millions of people worldwide each year. While most cases can be managed conservatively with physiotherapy and nonsteroidal anti-inflammatory medications, minimally invasive corticosteroid injections are the mainstay intervention for those not responsive to conservative treatment. Historically, spinal injections were performed in the absence of imaging guidance; however, imaging modalities, in particular fluoroscopy and computer tomography (CT), have become the standard of care in performing most of these procedures.

Transverse sinus stenting for treatment of papilloedema secondary to a large brain herniation into a dural venous sinus with associated tectal plate lesion: Case report and literature review.

Brain herniation into a dural venous sinus is a rare entity of unknown clinical significance without a clear relationship to raised intracranial pressure. There are yet to be detailed reports of interventional neuroradiology procedures involving sinus stenting across brain herniations. The authors of this paper present the first case of a stent placed across a large brain herniation into the transverse sinus in a patient with a tectal plate lesion and features of chronically raised intracranial pressure.

Precipitating hydrophobic injectable liquid (PHIL) embolic for the treatment of a uterine arteriovenous malformation: a technical report.

Objective: Uterine arteriovenous malformations (AVM) are unusual causes of vaginal bleeding. Although hysterectomy is the definitive treatment; uterine artery embolization (UAE) provides an alternative therapeutic option. This case presents a technical report of a uterine AVM treated successfully with transcatheter UAE using precipitating hydrophobic injectable liquid (PHIL) embolic agent.

Successful treatment of central nervous system myeloma manifesting as cauda equina nodules with intrathecal chemotherapy, lenalidomide and dexamethasone.

We report a case of central nervous system myeloma manifesting as cauda equina nodules, successfully treated with triple intrathecal (IT) chemotherapy, lenalidomide and dexamethasone. After presenting with multiple plasmacytomas which led to a diagnosis of non-secretory myeloma at age 56, the patient underwent multiple episodes of treatment for relapsing myeloma over a 7-year period. In March 2017, he presented with declining gait over a month with bilateral hip flexion weakness, absent lower limb reflexes and dorsal column loss.

Decision-making in the scheduling of endovascular treatment after brain arteriovenous malformation haemorrhage: a retrospective single centre study.

The appropriate timing for endovascular intervention after brain arteriovenous malformation (bAVM) rupture is not known. This paper aims to determine factors that lead to early endovascular intervention and to investigate whether early intervention has the same complication rate as late intervention in a single centre. All patients who underwent endovascular treatment for a ruptured bAVM at our institution in the period January 2007 and July 2010 were included in this retrospective observational study.

Resolution of renal failure 1 month after onset through angioplasty of renal artery stenosis.

The stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function (STAR) and revascularization versus medical therapy for renal-artery stenosis (ASTRAL) trials concluded that renal artery angioplasty was not superior to medical management in delaying progression to renal failure or controlling blood pressure in a selected population. (1,2) There were several criticisms of the STAR trial's methodology, and an important criticism of ASTRAL was that the patient was excluded if their clinician was uncertain of the value in correcting the stenosis. Anuric renal failure by renal artery stenosis is a rare occurrence and falls outside this criteria.

Endovascular treatment of very small intracranial aneurysms.

Object: Endovascular treatment of very small aneurysms poses a significant technical challenge for endovascular therapists. The authors review their experience with a series of patients who had intracranial aneurysms smaller than 3 mm in diameter.

Methods: Between 1995 and 2006, 97 very small aneurysms (defined for purposes of this study as < 3 mm in diameter) were diagnosed in 94 patients who were subsequently referred for endovascular treatment.

Endovascular treatment of intracranial microarteriovenous malformations.

Object: Microarteriovenous malformations (micro-AVMs) are an uncommon subgroup of brain AVMs defined by a nidus measuring < 1 cm in diameter. The clinical features, angiographic characteristics, and outcomes in patients with micro-AVMs who had been treated endovascularly after presenting with hemorrhage were reviewed to identify common features affecting prognosis.

Methods: Between 1997 and 2006, 25 patients (12 females and 13 males) with 26 micro-AVMs were treated.

Delayed visual deficits and monocular blindness after endovascular treatment of large and giant paraophthalmic aneurysms.

Objective: Paraophthalmic aneurysms may exert mass effect on the optic apparatus. Although surgical clipping and endovascular coiling of these aneurysms can be complicated by immediate postoperative visual deterioration, endovascular coil embolization has the unique risk of visual complications later (>24 h) in the perioperative period.

Methods: Six patients with a delayed onset of vision loss after technically successful coil embolization of paraophthalmic region aneurysms were identified.

Abciximab for thrombolysis during intracranial aneurysm coiling.

Introduction: Thrombotic events are a common and severe complication of endovascular aneurysm treatment with significant impact on patients' outcome. This study evaluates risk factors for thrombus formation and assesses the efficacy and safety of abciximab for clot dissolution.

Materials And Methods: All patients treated with abciximab during (41 patients) or shortly after (22 patients) intracranial aneurysm coil embolisation were retrieved from the institutional database (2000 to 2007, 1,250 patients).

Correlation of microalbumin and sialic acid with anthropometric variables in type 2 diabetic patients with and without nephropathy.

Aim: The objective of this study is to correlate microalbumin and sialic acid levels with anthropometric variables in type 2 diabetic patients with and without nephropathy.

Methods: This study was a case control study and included 108 Trinidadian subjects (aged 15-60 years) of which 30 were healthy individuals, 38 had type 2 diabetes, and 40 were of type 2 diabetic patients with nephropathy. Blood pressure and waist to hip ratio were recorded.

Embolisation of metachronous pseudoaneurysms complicating chronic pancreatitis.

Background: Pseudoaneurysm bleeding is a well-described complication of chronic pancreatitis. Reports of embolisation therapy for metachronous pseudoaneurysms in this condition are rare. We present such a patient and describe his management.

Idiopathic aneurysms of distal cerebellar arteries: endovascular treatment after rupture.

Introduction: Idiopathic ruptured aneurysms of distal cerebellar arteries (DCAAs) are rare, and their endovascular therapy (EVT) has as yet not been extensively reported. They are usually assumed to result from local arterial wall disruption rather than infection, unlike distal supratentorial artery aneurysms. This study was performed to audit their frequency, potential aetiology and results of EVT.

Clinics in diagnostic imaging (68). Intradural extramedullary spinal paraganglioma.

Paragangliomas rarely present as spine tumours. The correct diagnosis is generally not suspected pre-operatively and initial imaging is often non-specific. A 36-year-old man with low back pain, and progressive leg numbness and weakness, was found to have an expansile intradural extramedullary spinal tumour on radiographs and magnetic resonance imaging.

Case report: abdominal cocoon associated with tuberculous pelvic inflammatory disease.

Abdominal cocoon is a rare acquired condition in which there is encapsulation of the small bowel by a fibrous membrane. The authors describe a case wherein an organism was identified for the first time. The clinical, pathological and radiological features of this unusual disease are reviewed.

Non-operative management of haemobilia.

Background: The aim was to evaluate a non-operative approach to the management of haemobilia.

Methods: This was a retrospective analysis of patients presenting over 10 years with haemobilia. All patients had upper gastrointestinal endoscopy, abdominal ultrasonography and digital subtraction angiography.