Journal of neurointerventional surgery
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To evaluate the efficacy of vertebral augmentation (VA) in cancer patients. ⋯ VA provides pain relief for a majority of ACFs and MCFs. Increasing age may be predictive of pain relief outcomes in MCFs. There are special planning, imaging and technical considerations (eg, needle placement) in using VA to treat cancer patients.
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Embolization of intracranial arteriovenous malformations (AVMs) is generally a preoperative adjunctive procedure in the USA. However, sometimes embolization can result in complete angiographic obliteration of the AVM. There is significant controversy regarding the best management strategy for this subset of patients. There is a scarcity of literature predicting which embolized, angiographically obliterated AVMs are likely to recur and which ones are cured. We present our series of patients with complete obliteration of their AVMs from embolization. ⋯ A minority of intracranial AVMs can be safely obliterated with stand-alone embolization. Proximal occlusion of feeding arteries appears to be associated with recurrence. Prospective studies with longer follow-up and larger patient numbers are necessary.
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Case Reports
Combined microsurgical and endovascular treatment of a giant left middle cerebral artery aneurysm.
Giant fusiform aneurysms of the middle cerebral artery (MCA) bifurcation pose significant treatment challenges. A giant fusiform aneurysm of the left MCA in a pediatric patient, which persisted despite Hunterian ligation of the M1 and double barrel superficial temporal artery (STA) to M2 bypasses, is reported. The aneurysm was trapped by endovascular coiling of the feeding M2 trunk through the STA anastamosis. ⋯ However, in certain cases, flow reversal may not eliminate the aneurysm and continued aneurysm filling may occur through retrograde filling from the bypass recipient vessels. In these cases, endovascular trapping of the aneurysm may be undertaken through the bypass graft. The feasibility of this management scheme is demonstrated.