Endovascular treatment of anterior cranial base dural arteriovenous fistulas as a first-line approach: a multicenter study.

Objective: Anterior cranial fossa dural arteriovenous fistulas (DAVFs) have been almost exclusively considered as surgical lesions. However, new advances in endovascular technology have made the endovascular treatment (EVT) of ethmoidal DAVFs feasible. The aim of this study was to report the clinical and angiographic outcomes of patients harboring DAVFs of the anterior cranial fossa who had undergone EVT as a first-line approach.

Endovascular treatment of residual or recurrent intracranial aneurysms after surgical clipping.

Objective: Total aneurysm occlusion is crucial for the prevention of rebleeding of a ruptured aneurysm or to avoid rupture of an unruptured lesion. Both surgical and endovascular embolization fail to achieve complete aneurysm occlusion in all the cases. The objective of the study was to establish the safety and efficacy of endovascular treatment for previously clipped residual or recurrent aneurysms.

Endovascular Treatment of Tentorial Dural Arteriovenous Fistulas Using the Transarterial Approach as a First-Line Strategy.

Background: In recent decades, endovascular approaches have become the standard treatment for most tentorial dural arteriovenous fistulas (TDAVFs). Although endovascular treatment (EVT) is associated with better clinical outcomes, the angiographic occlusion rates are lower than those of surgical or combined approaches.

Objective: To evaluate the efficacy and safety of EVT for TDAVFs using the transarterial approach (TAA) as a first-line strategy.

The use of dual-lumen balloon for embolization of peripheral arteriovenous malformations.

Purpose: We aimed to evaluate the safety and feasibility of the embolization of peripheral arteriovenous malformation (AVM) with non-adhesive liquid agents (NALA) injected by dual-lumen balloons (DLB).

Methods: We conducted a multicenter retrospective study between January 2017 and June 2019, including patients with peripheral AVM embolized with NALA by DLB. Fourteen patients were included.

Transarterial Treatment of Cranial Dural Arteriovenous Fistulas: The Role of Transarterial and Transvenous Balloon-Assisted Embolization.

Background And Purpose: Treatment of dural arteriovenous fistulas can be performed by transarterial or transvenous accesses. For those fistulas located at a dural sinus wall, obliteration of the sinus might lead to a substantial risk of complications if the occluded sinus impairs normal venous drainage. For those fistulas with direct leptomeningeal venous drainage, navigation to reach the arteriovenous shunting point of a leptomeningeal vein is usually technically demanding.

Association between draining vein diameters and intracranial arteriovenous malformation hemorrhage: a multicentric retrospective study.

Purpose: Intracranial arteriovenous malformations (AVMs) cause hemorrhage, and the role of draining vein diameters in rupture risk is controversial. The aims of the present study were to investigate the variables related with intracranial AVM rupture and to examine the association of draining vein diameters and AVM hemorrhage.

Methods: Two hundred three patients were included in this study, of which 117 (57%) had unruptured AVMs, and 86 (43%) had ruptured AVMs.

Safety and Effectiveness of the Pipeline Flex Embolization Device With Shield Technology for the Treatment of Intracranial Aneurysms: Midterm Results From a Multicenter Study.

Background: The safety and efficacy of the first generation of the Pipeline Embolization Device (PED; Medtronic Inc) have been proven in large case series. Ischemic events are one of the most common complications following treatment of aneurysms with flow diverters. The new PED Flex with Shield technology (PED Shield; Medtronic Inc) was introduced to minimize the rate of complications.

Derivo Embolization Device for the Treatment of Intracranial Aneurysms.

Background and Purpose- Flow diverter technology improvements are necessary to provide safe and good results and enable the treatment of a larger variety of aneurysms. We report a nationwide experience with the Derivo Embolization Device in the treatment of intracranial aneurysms. Methods- BRAIDED (Brazilian Registry of Aneurysms Assigned to Intervention With the Derivo Embolization Device) is a multicenter, prospective, interventional, single-arm trial of the Derivo Embolization Device for the treatment of intracranial aneurysms.

The routes for embolization of dural carotid cavernous fistulas when the endovascular approach is indicated as a first-line strategy.

Introduction: Multiple ways to access the dural carotid cavernous fistula have been described. The aim of the present study was to assess the results of embolization of a dural carotid cavernous fistula via different routes using endovascular accesses as a first-line strategy.

Methods: A retrospective data analysis of a consecutive series of 63 patients presenting with dural carotid cavernous fistula was performed.

Republished: Recurrence of a totally occluded aneurysm after treatment with a pipeline embolization device.

Treatment with a pipeline embolization device (PED) is widely accepted as an excellent option for patients harboring giant, wide neck, saccular intracranial aneurysms. It has been shown to be safe and very effective. We describe a previously unreported case of a large middle cerebral artery aneurysm, related to the carotid tip, that was treated with a PED and coils.

Recurrence of a totally occluded aneurysm after treatment with a pipeline embolization device.

Treatment with a pipeline embolization device (PED) is widely accepted as an excellent option for patients harboring giant, wide neck, saccular intracranial aneurysms. It has been shown to be safe and very effective. We describe a previously unreported case of a large middle cerebral artery aneurysm, related to the carotid tip, that was treated with a PED and coils.

Occlusion rates of intracranial aneurysms treated with the Pipeline embolization device: the role of branches arising from the sac.

Objective: The aim of this study was to compare the clinical and angiographic outcomes of intracranial aneurysms with and without branches arising from the sac after Pipeline embolization device (PED) treatment.

Methods: This retrospective 2-center comparative study included 116 patients with 157 aneurysms that were treated with PEDs. Aneurysms were divided into 2 groups: one group had branches arising from the sac and the other group did not.

Dual-lumen balloon to increase onyx venous penetration in the treatment of spinal dural arteriovenous fistulas.

Purpose: Spinal dural arteriovenous fistulas (sDAVF) are the most common spinal vascular lesions. The arterialization of the recipient vein results in venous hypertension and chronic ischemia. Intravascular injection of acrylic glue in order to occlude the draining vein is the principle of endovascular treatment, but a significant portion of embolization procedures do not succeed.

Transvenous embolization of dural carotid cavernous fistulas: the role of liquid embolic agents in association with coils on patient outcomes.

Introduction: Transvenous embolization is the standard treatment for dural carotid cavernous fistulas (DCCF). Although various embolic materials have been used, the best embolic material for the treatment of DCCF is still unknown.

Objective: To assess the safety and efficacy of different embolic materials used for the endovascular treatment of DCCF.

Pipeline embolization device for the treatment of a traumatic intracranial aneurysm in a child.

Introduction: Traumatic intracranial aneurysms in children are rare and may occur as the result of closed or penetrating head trauma. Their natural history seems to be more aggressive. Most traumatic aneurysms have complex shape, tending to have a large neck or even a fusiform morphology.

Transorbital Cavernous Sinus Direct Puncture : Alternative to treat dural arteriovenous fistula.

Introduction: The authors present a retrospective series of their clinical experience in the treatment of cavernous dural arteriovenous fistulas (DAVF) by direct transorbital puncture of the cavernous sinus as an alternative to the endovascular approach.

Methods: Between October 2012 and September 2014, eight patients harboring cavernous DAVF underwent percutaneous treatment by direct transorbital puncture of the cavernous sinus at three institutions. All patients presented with ocular symptoms.

Preliminary Experience with the TransForm Occlusion Balloon Catheter: Safety and Potential Advantages.

Purpose: Balloon-assisted coiling (BAC) has made the treatment of aneurysms with complex shape and broad neck possible, especially during the acute phase of hemorrhage. The authors present a prospective series of their preliminary experience with the TransForm occlusion balloon catheter (TOBC).

Methods: Between September 2015 to February 2016 a total of 20 patients underwent endovascular treatment assisted by TOBC of which 19 had 20 untreated aneurysms and 1 patient harboring a meningioma was submitted to balloon test occlusion (BTO).

Endovascular treatment of pulsatile tinnitus associated with transverse sigmoid sinus aneurysms and jugular bulb anomalies.

Pulsatile tinnitus of vascular origin may arise in arterial or venous structures. Many authors have reported the association of pulsatile tinnitus with anomalies of dural venous sinuses and the jugular bulb. In such circumstances, mainly concomitantly with disabling tinnitus, endovascular treatment has been successfully employed.

A Novel Configuration of Pipeline Embolization Device for Internal Carotid Bifurcation Region Aneurysms: Horizontal Deployment.

Purpose: To describe a novel configuration of pipeline embolization device for internal carotid bifurcation region aneurysm, named horizontal stenting.

Clinical Presentation: A 64-year-old woman, with visual deficit, harboring a large wide-necked aneurysm located at the junction between left internal carotid artery and left A1 segment of anterior cerebral artery, was submitted to endovascular treatment. As she had pre-existing occlusion of left internal carotid, approach from the contralateral internal carotid was used to advance the pipeline embolization device through the anterior communicating artery and place the flow diverter horizontally across the neck (from M1 to A1).

Basilar Artery Fenestration Aneurysms: Endovascular Treatment Strategies Based on 3D Morphology.

Purpose: Basilar artery is the second most common site of fenestration, after the anterior communicating region. It is believed this variation predisposes a patient to posterior aneurysm formation and increases the complexity of the surgical anatomy. Endovascular management has become the first option to treat these aneurysms.

Endovascular treatment of isolated posterior inferior cerebellar artery dissecting aneurysms: parent artery occlusion or selective coiling?

Purpose: Isolated posterior inferior cerebellar artery dissecting aneurysms are rare lesions. Their underlying pathology, presentation, and natural history are poorly understood. Their treatment is controversial, and few data are available regarding the best treatment.