Jan, 2020
[A Case of Ruptured Arteriovenous Malformation Successfully Treated with Target Embolization for Pseudoaneurysm Detected Using Chronological Three-dimensional Digital Subtraction Angiography Fusion Images].
No shinkei geka. Neurological surgery
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- Volume
- 48
- Number
- 1
- First page
- 39
- Last page
- 45
- Language
- Japanese
- Publishing type
- Research paper (scientific journal)
- DOI
- 10.11477/mf.1436204131
We herein report a case of ruptured arterio-venous malformation(AVM)detected using three-dimensional digital subtraction angiography(3DDSA)fusion images and successfully treated with target embolization for pseudoaneurysm. A 50-year-old man with a history of AVM was admitted to our department for the treatment of ruptured high-grade AVM in the right parietal lobe. Although a bleeding point was not evident on DSA, the patient had re-rupture in the right ventricle, one month after admission. Chronological 3DDSA fusion images generated from 3DDSA images taken on admission and after re-rupture revealed a newly visualized intranidal pseudoaneurysm near a hematoma. Contrast-enhanced magnetic resonance imaging showed vessel wall enhancement along the posterior horn of the right ventricle;this enhancement corresponded to the location of the pseudoaneurysm. We planned target embolization for the intranidal pseudoaneurysm to prevent re-bleeding. The origin of the feeder was so steep that a microcatheter could not be advanced deeply, and embolization with 20% n-butyl-2-cyanoacrylate resulted in proximal occlusion. Follow-up angiography 1 week after embolization showed complete disappearance of the pseudoaneurysm, and the patient had no recurrence of aneurysm until one year.
- Link information
- ID information
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- DOI : 10.11477/mf.1436204131
- Pubmed ID : 31983687