Relevant bibliographies by topics / Cerebral arteriovenous malformations – Treatment

Academic literature on the topic 'Cerebral arteriovenous malformations – Treatment'

Author: Grafiati
Published: 10 December 2022
Last updated: 29 January 2023

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Journal articles on the topic "Cerebral arteriovenous malformations – Treatment"

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Heros, Roberto C. "Multimodality Treatment of Cerebral Arteriovenous Malformations: Modern Treatment of Cerebral Arteriovenous Malformations." World Neurosurgery 82, no. 1-2 (July 2014): 46–48. http://dx.doi.org/10.1016/j.wneu.2013.03.025.

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Aguiar, Paulo Henrique, Marco Antonio Stefani, Gustavo Rassier Isolan, Carlos Alexandre Zicarelli, and Apio Claudio Martins Antunes. "Cerebral Arteriovenous Malformations." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 23, no. 4 (March 29, 2018): 301–15. http://dx.doi.org/10.22290/jbnc.v23i4.1215.

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A significant improvement of central nervous system arteriovenous vascular malformations (AVM) outcome has been observed due to the advances in all modalities of diagnosis and treatment. The authors report the advances in diagnosis and integrated global treatment of AVM`s.
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Janicijevic, Milos. "Surgery of the arteriovenous cerebral malformations." Acta chirurgica Iugoslavica 55, no. 2 (2008): 11–16. http://dx.doi.org/10.2298/aci0802011j.

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According to the present technical possibilities modalities of the treatment of the arteriovenous cerebral malformations (surgery, embolization, radiosurgery) for direct neurosurgical excision of malformations remains of cases. Decision to operate is made separately for each malformation and is based on anticipation of the natural course of the illness, precise estimate of the risk from operation and on the estimate of the condition of the patient. Surgical technique is also chosen for each malformation separately, depending on its size, angioarchitecture, hemodynamic characteristics and localization. The following techniques are used: resection of the malformation "en blocque", coagulation of the lesion in situ, gradual marginal coagulation in the lesion cleavage, "backword technique", perivenous approach and excision of the complex malformations in several acts. The safety of the surgical excision is increased by preoperative and perioperative actions already described. Intraoperative problems and postoperative complications (brain edema, uncontrolled hemorrhage, intracerebral hematoma and others) were discussed.
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Fahed, Robert, Tim E. Darsaut, Charbel Mounayer, René Chapot, Michel Piotin, Raphaël Blanc, Vitor Mendes Pereira, et al. "Transvenous Approach for the Treatment of cerebral Arteriovenous Malformations (TATAM): Study protocol of a randomised controlled trial." Interventional Neuroradiology 25, no. 3 (February 4, 2019): 305–9. http://dx.doi.org/10.1177/1591019918821738.

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Background Transvenous embolisation is a promising technique but the benefits remain uncertain. We hypothesised that transvenous embolisation leads to a higher rate of arteriovenous malformation angiographic occlusion than transarterial embolisation. Methods The Transvenous Approach for the Treatment of cerebral Arteriovenous Malformations (TATAM) is an investigator initiated, multicentre, prospective, phase 2, randomised controlled clinical trial. To test the hypothesis that transvenous embolisation is superior to transarterial embolisation for arteriovenous malformation obliteration, 76 patients with arteriovenous malformations considered curable by up to two sessions of endovascular therapy will be randomly allocated 1:1 to treatment with either transvenous embolisation (with or without transarterial embolisation) (experimental arm) or transarterial embolisation alone (control arm). The primary endpoint of the trial is complete arteriovenous malformation occlusion, assessed by catheter cerebral angiography. Complete occlusions will be confirmed at 3 months, while incompletely occluded arteriovenous malformations, considered treatment failures, will then be eligible for complementary treatments by surgery, radiation therapy, or even transvenous embolisation. Standard procedural safety outcomes will also be assessed. Patient selection will be validated by a case selection committee, and participating centres with limited experience in transvenous embolisation will be proctored. Discussion The TATAM trial is a transparent research framework designed to offer a promising but still unvalidated treatment to selected arteriovenous malformation patients. Clinical Trial Registration-URL: http://www.clinicaltrials.gov . Unique identifier: NCT03691870.
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Jervis, S., and D. Skinner. "Screening for arteriovenous malformations in hereditary haemorrhagic telangiectasia." Journal of Laryngology & Otology 130, no. 8 (July 5, 2016): 734–42. http://dx.doi.org/10.1017/s0022215116008422.

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AbstractObjective:To determine whether patients with hereditary haemorrhagic telangiectasia were being screened according to international guidelines, and to review recent evidence in order to provide up-to-date guidelines for the initial systemic management of hereditary haemorrhagic telangiectasia.Methods:A retrospective case note analysis was conducted, assessing patients in terms of screening for: genetics, cerebral arteriovenous malformations, pulmonary and hepatic arteriovenous malformations, and gastrointestinal telangiectasia. Databases searched included Medline, the Cumulative Index to Nursing and Allied Health Literature, and Embase.Results:Screening investigations were most frequently performed for hepatic arteriovenous malformations and least frequently for genetics. Recent data suggest avoiding routine genetic and cerebral arteriovenous malformation screening because of treatment morbidities; performing high-resolution chest computed tomography for pulmonary arteriovenous malformation screening; using capsule endoscopy (if possible) to reduce complications from upper gastrointestinal endoscopy; and omitting routine liver enzyme testing in favour of Doppler ultrasound.Conclusion:Opportunities for systemic arteriovenous malformation screening are frequently overlooked. This review highlights the need for screening and considers the form in which it should be undertaken.
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Shchehlov, D. V., O. Ye Svyrydiuk, S. V. Chebanyuk, and M. B. Vyval. "Endovascular embolization of cerebral arteriovenous malformations." Ukrainian Interventional Neuroradiology and Surgery 37, no. 3 (February 3, 2022): 69–76. http://dx.doi.org/10.26683/2786-4855-2021-3(37)-69-76.

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Endovascular embolization is a critical component in the treatment of cerebral arteriovenous malformations. It can be used as an independent treatment modality or as an adjunct to microurgery or radiosurgery. The published literature in the PubMed database until September 2021 was reviewed with reference to the results of cerebral arteriovenous malformations embolization using liquid embolic agents. More scientific data reporting about total embolization of the cerebral arteriovenous malformations with a final cure. Although complications and mortality after arteriovenous malformations embolization have decreased significantly, but they still exist, and decisions about it usage should be weighed against its benefits during the planning phase. Treatment of arteriovenous malformations of the brain requires a multidisciplinary approach involving vascular neurosurgeons, endovascular interventionists and radiation oncologists, with a deep understanding of the natural course and combination of risks of multimodal treatment. Only such approach can increase the likelihood of a positive outcome of the cerebral arteriovenous malformations treatment.
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Eliahu, Karen, Florence Hofman, and Steven Giannotta. "A Systematic Review of Cerebral Arteriovenous Malformation Management." International Journal of Medical Students 5, no. 2 (August 31, 2017): 74–80. http://dx.doi.org/10.5195/ijms.2017.13.

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Cerebral Arteriovenous Malformation is a neurovascular lesion characterized by an abnormal connection between arterial and venous systems, resulting in a tangle of blood vessels lacking intervening capillaries. The goal of treatment is to prevent catastrophic hemorrhage, neurological injury, or death. Despite the availability of multiple cutting-edge treatment options there is little consensus on the most promising approaches for treatment due to the novelty of each Arteriovenous Malformation case. This analysis will link the various angioarchitectural characteristics and associated presentations of Arteriovenous Malformation to treatment modalities. In the era of personalized medicine, genomics-driven research to normalize by drawing parallels between Cerebral Cavernous Malformation and Arteriovenous Malformation, both of which are characterized by hemorrhage-prone vascular malformations, may provide insight for the development of pharmacological therapy. Understanding the underlying mechanisms and genes responsible for the symptoms will allow us to better treat patients in a non-invasive manner and paves future directions in Arteriovenous Malformation treatment.
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NAKAI, Yasunobu, Yoshiro ITO, Masayuki SATO, Kazuhiro NAKAMURA, Masanari SHIIGAI, Tomoji TAKIGAWA, Kensuke SUZUKI, et al. "Multimodality Treatment for Cerebral Arteriovenous Malformations." Neurologia medico-chirurgica 52, no. 12 (2012): 859–64. http://dx.doi.org/10.2176/nmc.52.859.

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Lee, Liang Shong. "Surgical Treatment of Cerebral Arteriovenous Malformations." Nosotchu 18, no. 6 (1996): 440. http://dx.doi.org/10.3995/jstroke.18.440.

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Gailloud, Philippe. "Endovascular Treatment of Cerebral Arteriovenous Malformations." Techniques in Vascular and Interventional Radiology 8, no. 3 (September 2005): 118–28. http://dx.doi.org/10.1053/j.tvir.2005.10.003.

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Dissertations / Theses on the topic "Cerebral arteriovenous malformations – Treatment"

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Storer, Kingsley Paul School of Medicine UNSW. "Cerebral arteriovenous malformations: molecular biology and enhancement of radiosurgical treatment." Awarded by:University of New South Wales. School of Medicine, 2006. http://handle.unsw.edu.au/1959.4/31942.

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Object Rupture of intracranial arteriovenous malformations is a leading cause of stroke in children and young adults. Treatment options include surgery and highly focused radiation (stereotactic radiosurgery). For large and deep seated lesions, the risks of surgery may be prohibitively high, while radiosurgery has a disappointingly low efficacy and long latency. Radiosurgery carries the most promise for significant advances, however the process by which radiosurgery achieves obliteration is incompletely understood. Inflammation and thrombosis are likely to be important in the radiation response and may be amenable to pharmacological manipulation to improve radiosurgical efficacy. Materials and methods Immunohistochemistry and electron microscopy were used to study normal cerebral vessels, cavernous malformations and AVMs, some of which had previously been irradiated. An attempt was made to culture AVM endothelial cells to study the immediate response of AVM endothelium to radiosurgery. The effects of radiosurgery in a rat model of AVM were studied using immunohistochemistry and the results used to determine the choice of a pharmacological strategy to enhance the thrombotic effects of radiosurgery. Results Vascular malformations have a different endothelial inflammatory phenotype than normal cerebral vessels. Radiosurgery may cause long term changes in inflammatory molecule expression and leads to endothelial loss with exposure of pro-thrombotic molecules. Ultrastructural effects of irradiation include widespread cell loss, smooth muscle cell (SMC) proliferation and thrombosis. Endothelial culture from AVMs proved difficult due to SMC predominance in initial cultures. Radiosurgery upregulated several endothelial inflammatory molecules in the animal model and may induce pro-thrombotic cell membrane alterations. The administration of lipopolysaccharide and soluble tissue factor to rats following radiosurgery led to selective thrombosis of irradiated vessels. Conclusions Inflammation and thrombosis are important in the radiosurgical response of AVMs. Lumen obliteration appears to be mediated by proliferation of cells within the vessel wall and thrombosis. Upregulation of inflammatory molecules and perhaps disruption of the normal phospholipid asymmetry of the endothelial and SMC membranes are some of the earliest responses to radiosurgery. The alterations induced by radiation may be harnessed to selectively initiate thrombus formation. Stimulation of thrombosis may improve the efficacy of radiosurgery, increasing treatable lesion size and reducing latency.
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Lindvall, Peter. "Hypofractionated conformal stereotactic radiotherapy in the treatment of AVMs and cerebral metastases." Doctoral thesis, Umeå : Univ, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-864.

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Peres, Carlos Michel Albuquerque. "Malformações arteriovenosas encefálicas: impacto da angioarquitetura nidal no resultado do tratamento radiocirúrgico isolado ou precedido de embolização." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5151/tde-16112017-110424/.

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Aspectos morfológicos do nido e embolização parcial neoadjuvante sem intenção de cura de malformações arteriovenosas encefálicas, precedendo a radiocirurgia, podem ter influência no resultado final do tratamento. Métodos: série consecutiva de 47 pacientes submetidos à radiocirurgia (1 a 5 sessões), precedida ou não por embolização com cianoacrilato. Acompanhamento clínico e radiológico mínimo de 36 meses. Resultados: a apresentação hemorrágica ocorreu em 68,1% dos pacientes tratados; destes, 62,5% portavam fístula arteriovenosa dentro da malformação arteriovenosa; 83,3% ectasia venosa e 90% restrição à drenagem venosa. A taxa de oclusão de embolização seguida de radiocirurgia foi de 46,1% e da radiocirurgia isolada foi de 52,4% (p=0,671). Foram identificados como fatores favoráveis à oclusão: baixo volume nidal, ausência de fístula arteriovenosa intranidal, maior dose de radiação e baixo grau na classificação das malformações arteriovenosas encefálicas baseadas na radiocirurgia (RBAS). Conclusões: o menor volume nidal (p < 0,001), o menor grau na escala RBAS (p=0,047), a ausência de fístula arteriovenosa intranidal (p=0,001) e a maior dose prescrita (p=0,001) tiveram correlação com resultado favorável no tratamento. Embolização seguida de radiocirurgia não foi superior à radiocirurgia isolada (p=0,772). A eliminação de fístulas arteriovenosas intranidais pela embolização pode aumentar a eficácia da radiocirurgia
Partial nidal embolization preceding radiosurgery of brain arteriovenous malformations (AVM) and some morphological nidal features may be related to final results. Methods: Analysis of a longitudinal cohort of 47 consecutive patients who underwent radiosurgery preceded or not by embolization. Embolizations were performed exclusively with n-butyl cyanoacrylate. Radiosurgery was delivered either as a single or divided up to 5 equal fractions. Clinical and radiological follow up of at least 36 months was obtained. Results: Hemorrhagic presentation was seen in 68.1% of the cases; 62.5% harbored intranidal arteriovenous fistulas (AVF), 83.3% had venous ectasias and 90% had venous outflow stenosis. The occlusion rate of embolization plus radiosurgery was 46.1% and radiosurgery alone was 52.4% (p = 0.671). Variables significantly associated with obliteration were lower nidus volume, lack of intranidal arteriovenous fistula, higher radiosurgical dose and lower grades in radiosurgical-based AVM scale (RBAS). Conclusions: a small nidus (p < 0.001), a lower RBAS grade (p = 0.047), no intranidal AVF (p = 0.001) and greater radiosurgical dose (p = 0.001) were associated to better results. Embolization followed by radiosurgery was not superior to radiosurgery alone (p = 0.772). Endovascular elimination of intranidal AVF\'s may help to promote radiosurgical occlusion
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Grieve, Joan Patricia. "Novel structural and functional imaging in cerebral arteriovenous malformations." Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/1446575/.

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Clarification of the angio-architecture and haemodynamic effects of cerebral arteriovenous malformations (AVMs) using non-invasive imaging may advance our knowledge and understanding of their natural history, resulting in improvements in the management of patients with these lesions. The aims of the work in this dissertation was to investigate the haemodynamic effects of AVMs and to determine whether newer non-invasive imaging techniques allow an accurate enough assessment of the angio-architecture of AVMs to be able to replace conventional digital subtraction angiography (DSA) in some clinical situations. The hypotheses were: 1. Non-invasive structural imaging techniques, such as CT angiography (CTA) and MR angiography (MRA), provide adequate structural and volumetric information to replace the more invasive technique of DSA.2. MR perfusion imaging is able to demonstrate the alteration of cerebral haemodynamics by AVMs. 6 Rapid frame rate DSA (RFRDSA) provides useful quantitative data on the blood flow within cerebral AVMs. In this work CT and MR angiography (CTA and MRA) were compared with conventional digital subtraction angiography (DSA). Twenty patients were examined with CTA and ten with MRA. Both techniques were able to detect most of the important angio-architectural features, but were not as accurate as DSA as decision-making tools, in particular because temporal resolution and nidus definition were poor. The use of gadolinium enhancement during MRA improved the visualisation of both nidus and draining veins. The nidal volume of ten AVMs was calculated from DSA and three magnetic resonance (MR) sequences. With biplanar DSA, an ellipsoid volume was calculated using orthogonal projections. MR images showed potential but were difficult to interpret due to varied appearances of flowing blood and, on gadolinium-enhanced MRA, the enhancement of abnormal brain. The cerebral haemodynamics of fifteen patients with AVMs were examined with contrast bolus tracking. This semi-quantitative technique was able to demonstrate consistent differences in cerebral blood flow and volume, mean transit time and time to minimum signal intensity in brain distant from the AVM. Changes in the perinidal regions were dominated by the presence of draining veins. A vascular phantom was calibrated to allow calculation of flow rates from rapid frame rate DSA. The technique for quantifying flow was assessed in five patients and compared with values measured by transcranial doppler. It was not possible to calculate accurately flow and velocity for AVM feeding vessels. These imaging modalities allowed improved appreciation of the structure and haemodynamic effects of cerebral AVMs but further development is needed before they will be of use as reliable clinical tools.
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Söderman, Michael. "Volume determination and predictive models in the management of cerebral arteriovenous malformations /." Stockholm, 2000. http://diss.kib.ki.se/2000/91-628-4136-X/.

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Verlaan, Dominique Jacqueline. "Genetic investigation of cerebrovascular disorders : cerebral cavernous malformations and intracranial aneurysms." Thesis, McGill University, 2007. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=103306.

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Cerebral Cavernous Malformations (CCM) and Intracranial Aneurysms (IA) are cerebrovascular disorders that can lead to a hemorrhagic stroke and other neurological problems. CCMs are characterized by abnormally enlarged capillary cavities while IAs are saccular outpouchings of intracranial arteries. CCM is found in approximately 0.4% to 0.9% of the population, while IA is more common (3-6%).
This dissertation aimed to add to the body of research for CCM and IA and was divided into two parts. Initial work focused on the characterization and identification of the genes involved in CCM; the second phase focused on the identification of a susceptibility gene for IA.
In the first phase, the CCM1, CCM2 and CCM3 genes were characterized in families and in sporadic cases of CCM. In both cohorts, a causative mutation was identified in 71% of the cases. Subsequent MLPA analysis of subjects with no CCM mutations revealed that large genomic deletions and duplications are a common cause of CCM. In addition, investigation of CCM1 point mutations revealed that these were not simple missense mutations but that they rather activated cryptic splice-donor sites and caused aberrant splicing. Furthermore, the genetic predisposition to CCM in sporadic cases with a single lesion was determined to be different from sporadic cases with multiple malformations. Investigation into the loss of heterozygosity demonstrated a plausible mechanism for CCM pathogenesis involving a second somatic hit at the site of the lesion, suggesting that CCM may be caused by a complete loss of CCM protein function.
In the second phase, a genome-wide scan of a large family and subsequent linkage analysis using a monogenic approach identified a susceptibility locus for IA (ANIB4).
As a result of this research, we have greatly contributed to the field of CCM, most specifically to its clinical diagnosis. A greater understanding of the genetics involved in CCM will facilitate and permit better management care for patients. Furthermore, the possibility of identification of a gene with a major effect for IA will give us more insight into which pathways are involved in IA formation.
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Orlowski, Piotr. "Treatment planning for the embolization of arteriovenous malformations of the brain." Thesis, University of Oxford, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.669969.

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Sonier, Marcus. "IMRT treatment planning for arteriovenous malformations : patient stratification and dosimetric quality assurance." Thesis, University of British Columbia, 2013. http://hdl.handle.net/2429/43782.

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Stereotactic Radiosurgery is a treatment of choice for Arteriovenous Malformations (AVMs) in anatomical locations associated with a risk of surgical complications. However, SRS has a risk of toxicity due to radiation injury to brain tissue. Therefore, use of intensity-modulated radiotherapy (IMRT) has been advocated because, compared to 3D Conformal Radiotherapy (3DCRT), it leads to improved PTV conformity and Normal Tissue (NT) sparing. The aim of this study was: 1) to develop stratification rules for AVM patients based on benefits they receive from IMRT; 2) to assess optimized dose distributions against prospectively collected data for symptomatic radiation injury; 3) to test and benchmark IMRT QA procedures for patient applications with the iPlan system. Thirty-one AVM patients previously treated with 3DCRT were replanned using static gantry IMRT for BrainLab microMLC using the iPlan system, with the 3DCRT plans as a reference. First, PTV constraints were applied and the conformity of the prescription dose to the PTV was compared between the treatment techniques. Next, NT constraints were introduced into the IMRT plans at the 7 and 12Gy isodoses. These constraints were manipulated to achieve maximum NT sparing while maintaining PTV coverage. Then, NT volumes receiving 7 and 12Gy were compared between the plan types. Finally, ion chamber and film dose verification were performed to scrutinize the accuracy of the IMRT improvements and determine the clinical validity of each plan. Examination of conformity index, NT max dose, and 7 and 12Gy isodose volumes showed a separation of patients into those who did and did not benefit from IMRT for two plan types: PTV Only and OAR Low. For PTV Only, each subset of patients received improvements of 0.10-0.68, 4.0-12.3%, 0-7.072cc, and 0.5-4.496cc, respectively, while, for OAR Low, patients received improvements of 0.10-0.58, 0-6.5%, 1.0-7.952cc, and 0.5-3.704cc, respectively. The 12Gy volume results translated to a decrease in the probability of symptomatic injury by 0.3-11.2% and 0.3-9.3% for PTV Only and OAR Low IMRT. In conclusion, this work indicates the potential for significant patient improvements when treating AVMs and provides rules to predict which patients are likely to benefit from IMRT.
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White, A. H. "Mathematical modelling of the embolization process in the treatment of arteriovenous malformations." Thesis, University College London (University of London), 2008. http://discovery.ucl.ac.uk/1446199/.

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Arteriovenous malformations (AVMs) are neurological defects where the arte rial and venous systems are connected directly with no intervening capillaries. The absence of capillaries means that blood at high pressure is entering the venous system directly and so a venous haemorrhage is possible. AVMs can be treated by embolization in which a glue is injected into a local artery with the aim of diverting the blood flow away from the AVM and so reducing the risk of haemorrhage. The thesis introduces a mathematical model for the embolization process by considering a two phase fluid dynamical model. Both numerical and as ymptotic techniques are used to analyse the flow of the two fluids in different configurations. At the start of the thesis both the fluids are treated as inviscid and their interaction modelled using analytical techniques such as conformal mapping theory. Next, viscous effects are included in the model by assuming that both fluids are present in a thin wall layer as would be the case just be fore the glue has set. Finally the problem of both fluids being present in the core of the artery is treated numerically using the Volume of Fluid method. A detailed account of this method is given. The method essentially tracks the interface between the glue and the blood over time and thus can model how the glue spreads, for instance just after injection.
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Souza, Evandro César de. "Resultados do tratamento radiocirúrgico de doentes com malformações arteriovenosas encefálicas classificadas como graus 3A, 3B, 4 ou 5 previamente submetidos ou não à embolização." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/5/5138/tde-20092010-120333/.

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Introdução: O risco do tratamento das malformações arteriovenosas encefálicas (MAVEs) é proporcional à sua graduação. O processo de seleção da técnica empregada depende, além da natureza e localização das MAVEs, das condições clínicas e idade dos doentes e da disponibilidade de profissionais treinados e de equipamentos apropriados no ambiente onde o doente é tratado. Objetivo: Avaliar a eficácia da radiocirurgia e da embolização prévia ao tratamento radiocirúrgico das MAVEs classificadas como graus 3A, 3B, 4 ou 5. Métodos e Resultados: O trabalho baseou-se na observação retrospectiva de prontuários clínicos e de arquivos de imagens de 90 doentes com diagnóstico de MAVEs classificadas como graus 3A, 3B, 4 ou 5 submetidos a tratamento com radiocirurgia precedida ou não de embolização no Departamento de Radioterapia e Radioterapia Estereotáctica, Neuroradiologia Intervencionista e Neurocirugia da Real e Benemérita Associação Portuguesa de Beneficência de São Paulo, de outubro de 1993 a outubro de 2008. As idades dos doentes variaram de sete a 60 anos (média de 30,6 anos ± 11,59 anos, mediana de 28 anos). Eram do sexo feminino 46 (51,1%) doentes. Todos foram submetidos a três exames de ressonância magnética (RM) ou tomografia computadorizada (TC) no primeiro ano de acompanhamento e a um exame de RM ou TC do encéfalo no segundo e terceiro anos. Quando um dos exames sugeriu oclusão da MAVE ou o período de acompanhamento foi maior que três anos, os doentes foram submetidos à angiografia digital do encéfalo. Em 51 (56,7%) dos 90 doentes tratados ocorreu oclusão completa da MAVE após a primeira radiocirurgia (1ª Rc), em 21 (23,3%) foram evidenciadas complicações clínica em 36 (40,0%), foram visibilizadas anormalidades no exame de RM. Em 30 (33,3%) doentes evidenciou-se hipersinal no encéfalo em T2 na RM xvi e, em seis (6,7%), radionecrose. Trinta e dois(82,0%) dos 39 doentes que não apresentaram oclusão completa da MAVE após a 1ª Rc foram submetidos à segunda radiocirurgia (2ª Rc). Ocorreu oclusão completa em 12 (37,5%) destes doentes, instalaram-se complicações clínicas em cinco (15,6%) e, anormalidades no exame de RM em oito (25,0%), ou seja, hipersinal em T2 na RM em três (9,5%) e radionecrose em cinco (15,6%). Conclusão: Concluiu-se que a radiocirurgia foi eficaz no tratamento das MAVEs graus 3A, 3B, 4 e 5, que as MAVEs classificadas como grau 3B devem tratadas, preferencialmente, apenas com radiocirurgia e que as MAVEs classificadas como 3A, 4 e 5 devem ser submetidas à embolização previamente à radiocirugia para reduzir-se sua graduação e seu fluxo sanguíneo
Introduction: The risk of treatment of the cerebral arteriovenous malformations (AVM) is proportional to their grade and is affected by the method used. The selection of the AVM therapeutic method depends of the vascular pattern and anatomical site, clinical condition and age of the patient, experience of the treating team and of the equipment available. Objectives: This study aimed the evaluation of the efficacy of the radiosurgical treatment of Grade 3A, 3B, 4 and 5 cerebral AVMs in patients previosly treated or not with embolization. Methods and Results: The data of the clinical notes and the computed tomography (CT) and magnetic ressonance (RM) images of the brain of 90 patients with Grade 3A, 3B, 4 or 5 cerebral embolised or not AVMs treated with radiosurgery at the Department of Radiotherapy, Stereotactic Radiotherapy, Interventional Neuroradiology and Neurosurgery at Real e Benemerita Associação Portuguesa de Beneficência de São Paulo were retrospectively reviewed. The ages of the patients ranged from 7 to 60 years of (average = 30.6 ± 11.59 years; median = 28 years) and 46 (51.1%) were female. During the first year after treatment three MR or CT scans of the brain were evaluated and one at the end of the 2nd and 3rd years after the treatment one MR or CT scan were re-evaluated respectively. When the brain scans suggest AVM occlusion, cerebral angiography was performed. In 51 of the 90 patients (56.7%) there was complete occlusion of the AVM after one radiosurgical treatment; 21 of the patients (23.3%) had clinical complications. In 36 patients (40.0%) new abnormalities of the MR became evident. Thirty (33.3%) presented T2 hypersignal and six (6.7%), had radionecrosis. From the 39 patients who did not had complete occlusion of the AVM, 32 (82.0%) had a second radiosurgical course of treatment; in 12 xviii (37.5%) the AVM became completely occluded but five (15.6%) had clinical complications. Eight (25.0%) of these patients presented new abnormalities at the MR scan of the brain; three (9.5%) had T2 hypersignal and five (15.6%) radionecrosis. Conclusions: Radiosurgery was effective in the treatment of Grade 3A, 3B, 4 and 5 cerebral AVMs , Grade 3B cerebral AVM should be treated only with radiosurgery without previous embolization, and Grade 3A, 4 and 5 AVMs should be treated with embolization to reduce their AVM grade and blood flow prior to radiosurgery
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Books on the topic "Cerebral arteriovenous malformations – Treatment"

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Samson, Duke S., H. Hunt Batjer, and Philip E. Stieg. Intracranial arteriovenous malformations. New York: Informa Healthcare, 2007.

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Shokei, Yamada, ed. Arteriovenous malformations in functional areas of the brain. Armonk, NY: Futura Pub. Co., 1999.

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Yaşargil, Mahmut Gazi. AVM of the brain. Stuttgart: Thieme, 1987.

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J, Teddy P., Valavanis A, and Duvernoy Henri M, eds. AVM of the brain, histology, embryology, pathological considerations, hemodynamics, diagnostic studies, microsurgical anatomy. Stuttgart: Georg Thieme, 1987.

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1953-, Steiger Hans-Jakob, ed. Neurosurgery of arteriovenous malformations and fistulas: A multimodal approach. Wien: Springer, 2002.

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Cavernous malformations of the nervous system. Houndmills, Basingstoke, Hampshire: Cambridge University Press, 2011.

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Kathie's miracle. [Place of publication not identified]: Xlibris, 2010.

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Maciunas, Robert J. Endovascular neurological intervention. Park Ridge, Ill: American Association of Neurological Surgeons, 1995.

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Spinelli, Allison, and Liang Huang. Arteriovenous Malformation. Edited by David E. Traul and Irene P. Osborn. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850036.003.0006.

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Arteriovenous malformation (AVM) is an abnormal connection between arteries and veins, bypassing the capillary system, which may occur in the brain or the spinal cord. AVMs are challenging to diagnose, and the symptoms may be subtle or dramatic. The location and extent of the lesion will determine its potential for morbidity as these lesions also affect a young population. Most importantly, the technology and evolution of treatment for AVMs has changed dramatically over the past two decades and now incorporates interventional neuroradiology and stereotactic radiation. Management options include conservative management, surgical resection, endovascular embolization, and stereotactic surgery. This chapter’s discussion will cover surgical and interventional modes of treatment of cerebral AVMs.
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Renfrow, Jaclyn J., Aqib H. Zehri, Kyle M. Fargen, Jasmeet Singh, John A. Wilson, and Stacey Q. Wolfe. Management of Intracranial Vascular Lesions During Pregnancy. Edited by Emma Ciafaloni, Cheryl Bushnell, and Loralei L. Thornburg. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0016.

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Management of cerebral vascular lesions in pregnancy requires special consideration to an altered natural history in the pregnant patient, such as a higher rupture rate of arteriovenous malformations. Additionally, treatment challenges exist including radiation exposure, medication selection, optimal treatment timing, and modalities. If identified prior to a pregnancy most vascular lesions warrant a definitive treatment discussion to circumvent the risks associated with an intracranial hemorrhage during pregnancy. The treatment team consists of a multidisciplinary approach involving neurosurgeons, anesthesiologists, neurointensivists, and obstetricians.
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Book chapters on the topic "Cerebral arteriovenous malformations – Treatment"

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Renowden, Shelley, and Fergus Robertson. "Endovascular Treatment of Cerebral Arteriovenous Malformations." In Interventional Neuroradiology, 127–49. London: Springer London, 2013. http://dx.doi.org/10.1007/978-1-4471-4582-0_10.

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U, Hoi Sang. "Treatment of Deep Basal Cerebral Arteriovenous Malformations." In New Trends in Management of Cerebro-Vascular Malformations, 422–25. Vienna: Springer Vienna, 1994. http://dx.doi.org/10.1007/978-3-7091-9330-3_75.

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Kemeny, Andras A., Matthias W. R. Radatz, Jeremy G. Rowe, Lee Walton, and Paul Vaughan. "Gamma Knife Treatment for Cerebral Arteriovenous Malformations." In Radiosurgery and Pathological Fundamentals, 206–11. Basel: KARGER, 2007. http://dx.doi.org/10.1159/000100115.

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Richling, B., and G. Bavinzski. "Embolization Techniques in the Treatment of Cerebral Arteriovenous Malformations." In Advances in Neurosurgery, 41–45. Berlin, Heidelberg: Springer Berlin Heidelberg, 1991. http://dx.doi.org/10.1007/978-3-642-76182-9_8.

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Aspoas, A. R., A. D. Mendelow, J. Arrotegui, and A. Gholkar. "Outcome from Multimodality Treatment of Arteriovenous Malformations." In New Trends in Management of Cerebro-Vascular Malformations, 512–14. Vienna: Springer Vienna, 1994. http://dx.doi.org/10.1007/978-3-7091-9330-3_87.

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Da Pian, R., A. Pasqualin, R. Scienza, G. Barone, S. Perini, and A. Benati. "Further Experience in the Treatment of Cerebral Arteriovenous Malformations with Embolization Plus Surgery." In New Trends in Management of Cerebro-Vascular Malformations, 495–502. Vienna: Springer Vienna, 1994. http://dx.doi.org/10.1007/978-3-7091-9330-3_84.

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Barcia-Salorio, J. L., J. A. Barcia, F. Soler, G. Hernández, and J. M. Genovés. "Stereotactic Radiotherapy plus Radiosurgical Boost in the Treatment of Large Cerebral Arteriovenous Malformations." In Advances in Stereotactic and Functional Neurosurgery 10, 98–100. Vienna: Springer Vienna, 1993. http://dx.doi.org/10.1007/978-3-7091-9297-9_22.

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Zhang, Yongxin, and Qinghai Huang. "The Role of Veins in Arteriovenous Malformation and Fistula, Pathophysiology and Treatment." In Cerebral Venous System in Acute and Chronic Brain Injuries, 163–72. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-96053-1_10.

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Gruber, Andreas, Gerhard Bavinzski, Klaus Kitz, Stephan Barthelmes, Magdalena Mayr, and Engelbert Knosp. "Multimodality Management of Cerebral Arteriovenous Malformations with Special Reference to AVM-Related Hemorrhages During Ongoing Staged Treatment." In Acta Neurochirurgica Supplement, 153–58. Cham: Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-29887-0_22.

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Sellar, Robert J. "Cerebral Arteriovenous Malformations." In Endovascular Neurosurgery, 73–96. London: Springer London, 2000. http://dx.doi.org/10.1007/978-1-4471-3659-0_5.

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Conference papers on the topic "Cerebral arteriovenous malformations – Treatment"

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Calvo, William J., Baruch B. Lieber, Ajay K. Wakhloo, and L. Nelson Hopkins. "Improved Histologic Analysis of Component Distribution and Wall Behavior in Cyanoacrylate-Embolized Vessels." In ASME 2001 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2001. http://dx.doi.org/10.1115/imece2001/bed-23131.

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Abstract Use of embolic agents is currently an accepted treatment modality among neurointerventional clinicians in order to completely occlude abnormal shunts in the cerebral vasculature known as arteriovenous malformations or AVMs. The first cyanoacrylate polymer recently approved by the US Food and Drug Administration for use in humans is n-butyl 2-cyanoacrylate (NBCA). In order to control the polymerization time of NBCA, as well as to opacify the mixture for angiographic visualization, an iodized poppyseed oil-based contrast agent (Lipiodol) is added to the NBCA. Glacial acetic acid is also used to delay polymerization further by decreasing the pH of the mixture.
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Divani, A. A., B. B. Lieber, A. K. Wakhloo, and L. N. Hopkins. "Characterization of Enbucrilate Kinetics in a Model of Arteriovenous Malformation in Swine." In ASME 2000 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/imece2000-2548.

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Abstract Endovascular embolization of cerebral arteriovenous malformations (AVMs) has become an acceptable treatment. One commonly used embolic agent is n-butyl 2-cyanoacrylate (NBCA). The key to curative embolization of an AVM is complete glue casting of the arteriovenous transition (nidus) that requires precise knowledge of NBCA polymerization dynamics and its interaction with the arterial wall. We have created a model of a human AVM [1] in the rete of swine to investigate NBCA behavior. Embolizations were performed in both in acutely prepared endovascular AVM models as well as in surgically prepared AVM models where the vasculature was allowed to adjust to altered hemodynamic conditions. 30 AVM models were created and five embolic agent compositions were used to embolize the retia, yielding six samples for each glue composition. The retia were harvested and high-resolution radiographic images were obtained. The images were analyzed for penetration depth of the various mixtures vis-a-vis the prevailing hemodynamic condition just prior to embolization. Image processing tools and mathematical modeling were applied to predict the behavior of NBCA polymerization.
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Gounis, Matthew J., Baruch B. Lieber, and L. N. Hopkins. "Endovascular Embolization With Cyanoacrylate Mixtures: An In Vivo Study of Polymerization Kinetics." In ASME 2001 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2001. http://dx.doi.org/10.1115/imece2001/bed-23011.

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Abstract A cerebral arteriovenous malformation (AVM) is a congenital vascular lesion of the brain composed of a complex tangle of arteries and veins, which are linked by one or more fistulae [1]. Arterial blood is shunted through the AVM directly to the venous system, precluding arterial blood from perfusing adjacent brain structures. The most common presentation of this disease is cerebral hemorrhage secondary to AVM rupture, with an associated mortality of 15% and a morbidity of 50% [1]. One modality to treat this pathology is endovascular embolization. Generally, endovascular embolization serves as an adjunct treatment to either surgery or radiosurgery, but is a curative treatment in approximately 15% of AVM cases [2]. The most common embolic agent used to occlude AVMs is a mixture of n-butyl 2-cyanoacrylate (NBCA) and Lipiodol®. NBCA is a rapidly polymerizing liquid adhesive that polymerizes with contact to blood. Lipiodol® is an ethiodized oil, which imparts radiopacity to the embolic mixture. Moreover, Lipiodol® has been reported to delay the polymerization of NBCA [3]. To further increase the polymerization time of NBCA, minute quantities of glacial acetic acid (GAA) may be added to the embolic mixture.
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Dholke, Harshal, Mohan Rao, and Manas Panigrahi. "23. Intraoperative management of cerebral arteriovenous malformations: Our experience." In 15th Annual Conference of the Indian Society of Neuroanaesthesiology and Critical Care. Thieme Medical and Scientific Publishers Private Ltd., 2014. http://dx.doi.org/10.1055/s-0038-1646102.

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Hassan, Ahmed Attia Ahmed, Ali Hassan Elmokadem, Ahmed Bahaa Elden Elserwi, Mohamed Metwally Abo El Atta, and Talal Ahmed Youssef Amer. "Endovascular Management of Cerebral Arteriovenous Malformations: Technical and Clinical Outcome." In PAIRS Annual Meeting. Thieme Medical and Scientific Publishers Pvt. Ltd., 2020. http://dx.doi.org/10.1055/s-0041-1729057.

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Wang, A., E. Connolly, R. Solomon, S. Lavine, and P. Meyers. "E-070 Curative treatment for low grade arteriovenous malformations." In SNIS 16TH ANNUAL MEETING. BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd., 2019. http://dx.doi.org/10.1136/neurintsurg-2019-snis.145.

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Demyanovskaya, M., N. Strelnikov, A. Moskalev, and K. Orlov. "E-089 Deep cerebral arteriovenous malformations: comparison between transvenous and transarterial approaches." In SNIS 15TH ANNUAL MEETING, July 23–26, 2018, Hilton San Francisco Union Square San Francisco, CA. BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd., 2018. http://dx.doi.org/10.1136/neurintsurg-2018-snis.165.

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Saied, S. "EP752 Medical treatment of uterine arteriovenous malformations: a case report." In ESGO Annual Meeting Abstracts. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/ijgc-2019-esgo.804.

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Ni Bhuachalla, CF, A. Brady, TM O'Connor, N. Colwell, and M. Murphy. "Low Prevalence of Cerebral Arteriovenous Malformations in Irish Patients with Hereditary Haemorrhagic Telangiectasia." In American Thoracic Society 2009 International Conference, May 15-20, 2009 • San Diego, California. American Thoracic Society, 2009. http://dx.doi.org/10.1164/ajrccm-conference.2009.179.1_meetingabstracts.a5780.

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Kiselev, V., A. Perfilev, A. Sosnov, and R. Gafurov. "E-091 Transvenous approach in the endovascular embolization of the cerebral arteriovenous malformations." In SNIS 15TH ANNUAL MEETING, July 23–26, 2018, Hilton San Francisco Union Square San Francisco, CA. BMA House, Tavistock Square, London, WC1H 9JR: BMJ Publishing Group Ltd., 2018. http://dx.doi.org/10.1136/neurintsurg-2018-snis.167.

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Reports on the topic "Cerebral arteriovenous malformations – Treatment"

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Sirakov, Stanimir, Alexander Sirakov, Krasimir Minkin, Hristo Hristov, and Vasil Karakostov. The Bulgarian Experience in Endovascular Treatment of Cerebral Arteriovenous Malformations. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, January 2018. http://dx.doi.org/10.7546/crabs.2018.01.15.

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Sirakov, Stanimir, Alexander Sirakov, Krasimir Minkin, Hristo Hristov, and Vasil Karakostov. The Bulgarian Experience in Endovascular Treatment of Cerebral Arteriovenous Malformations. "Prof. Marin Drinov" Publishing House of Bulgarian Academy of Sciences, January 2018. http://dx.doi.org/10.7546/grabs2018.1.15.

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