Surgical Neuroangiography, Vol 2: Part 2.1 & Part 2.1

Berenstein, A.

1ª Edición Marzo 2004

Inglés

1271 pags

8000 gr

21 x 28 x 7 cm

ISBN 9783540416685

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About this book

Surgical Neuroangiography: Clinical and Interventional Aspects in Adults covers a variety of protocols and strategies combining functional vascular anatomy with a complete appreciation of the various disease processes, their pathophysiology, clinical presentation, and natural history, as well as recent technological advances. The newer endovascular techniques that apply to embolization of aneurysms, vascular malformations, and tumors of the spine, spinal cord, brain, and maxillofacial areas are reviewed. Novel techniques of revascularization for occlusive vascular diseases in the brachiocephalic and cerebral vasculature are expanding and revolutionizing the field. Implementing optimally efficient and safe strategies for occlusion or revascularization of arterial or venous structures requires the knowledge of collateral circulation covered in this volume. Alejandro Berenstein, Pierre Lasjaunias, and Karel ter Brugge, pioneers in the field with over 20 years of experience, present the second volume of the second edition of Surgical Neuroangiography, combining volumes 2, 4 and 5 of the previous edition and adding a new section, "Occlusive Vascular Diseases." Comprehensive, practice-oriented work on vascular intervention in adults and children Written by the leading experts with many years' experience in research and teaching Richly illustrated overview of all treatment modalities

1 Occlusive Vascular Disease

1.1 Introduction
1.2 Arterial Occlusive Disease
1.2.1 Cerebrovascular Physiology
1.2.1.1 The Blood–Brain Barrier
1.2.1.2 Cerebral Blood Flow
1.2.1.3 Cerebral Autoregulation
1.2.1.4 Cerebral Blood Volume
1.2.1.5 Blood Viscosity
1.2.1.6 Metabolism in Cerebral Blood Flow
1.2.1.7 Carbon Dioxide Reactivity
1.2.1.8 Oxygen Reactivity
1.2.1.9 Nitrous Oxide in Cerebral Circulation
1.2.1.10 Other Factors
1.2.2 Arterial Ischemic Stroke
1.2.2.1 Definition
1.2.2.2 Neuronal Metabolism and Cerebral Ischemia
1.2.2.3 Selective Neuronal Vulnerability
1.2.2.4 Hemodynamic Effects of Ischemia
1.2.2.5 Nitrous Oxide and Cerebral Ischemia
1.2.2.6 Window of Opportunity
1.2.2.7 Neutrophil
1.2.3 Atherosclerosis
1.2.3.1 Introduction
1.2.3.2 Epidemiology
1.2.3.3 Pathogenesis
1.2.3.4 Mechanisms of Atherogenesis
1.2.3.5 Fatty Streak
1.2.3.6 Fibrous Plaque
1.2.3.7 Unstable Fibrous Plaques
1.2.3.8 Complicated Plaque
1.2.3.9 Carotid Atherosclerosis
1.2.3.10 Conclusion
1.2.3.11 Neuroimaging of Ischemic Stroke
1.2.4 Ischemic Stroke Treatment
1.2.4.1 Medical Treatment of Acute Stroke
1.2.4.2 Thrombolytic Therapy: Introduction
1.2.4.3 Thrombolytics (IV)
1.2.4.4 Recombined Tissue Plasminogen Activator
1.2.4.5 Streptokinase
1.2.4.6 Antiplatelets
1.2.4.7 Coumadin Versus Aspirin
1.2.4.8 Neuroprotective Agents
1.2.4.9 Pharmacological Properties of Neuroprotective Drugs
1.2.4.10 Binding Properties
1.2.4.11 Angiographic Evaluation
1.2.4.12 Middle Cerebral Artery Stroke: Natural History
1.2.4.13 Local Intra-arterial Thrombolysis in the Anterior Circulation
1.2.4.14 Internal Carotid Artery Occlusion
1.2.4.15 Carotid Dissection
1.2.4.16 Central Retinal Artery Occlusion
1.2.4.17 Internal Carotid Artery Stenosis Above the Carotid Bulb
1.2.4.18 General Organization of a Stroke Emergency Team
1.2.4.19 Evolving Treatment Strategies
1.2.5 Extracranial Carotid Artery Stenosis
1.2.5.1 Introduction
1.2.5.2 Natural History
1.2.5.3 Carotid Bruit
1.2.5.4 Imaging
1.2.5.5 Treatment
1.2.5.6 Symptomatic Carotid Stenosis
1.2.5.7 Asymptomatic Carotid Stenosis
1.2.5.8 Restenosis After Carotid Endarterectomy
1.2.6 Carotid Angioplasty and Stenting
1.2.6.1 Introduction
1.2.6.2 Techniques of Carotid Angioplasty and Stenting
1.2.6.3 Intimal Hyperplasia and Restenosis
1.2.6.4 Follow-up Monitoring
1.2.7 Posterior Circulation Stroke (Stroke Prevention)
1.2.7.1 Introduction
1.2.7.2 Clinical Presentation
1.2.7.3 Pretherapeutic Evaluation in Cerebral Vascular Insufficiency
1.2.7.4 Management of Posterior Circulation Insufficiency
1.2.7.5 Basilar Thrombosis
1.2.7.6 Takayasu’s Arteritis
1.2.8 Cerebral Angioplasty
1.2.8.1 Vasospasm
1.3 Venous Occlusive Disease
1.3.1 Etiology
1.3.2 Incidence
1.3.3 Clinical Presentation and Natural History
1.3.4 Imaging
1.3.5 Treatment
Appendix

2 Dural and Bony Tumors

2.1 Introduction
2.2 Meningiomas
2.2.1 Epidemiology
2.2.1.1 Origin
2.2.1.2 Incidence
2.2.1.3 Association of Meningiomas with Other Tumors
2.2.1.4 Sex Hormone Receptors in Meningiomas
2.2.1.5 Chromosomal Patterns in Meningiomas
2.2.1.6 Meningiomas in Children
2.2.1.7 Familial Occurrence
2.2.1.8 Meningioma Incidence, Prevalence, and Mortality
2.2.1.9 Etiology of Human Meningiomas
2.2.1.10 Oncogenic Viruses
2.2.2 Pathology
2.2.2.1 Growth and Spread
2.2.2.2 Malignant Meningioma
2.2.2.3 Angioblastic Meningioma and/or Hemangiopericytoma
2.2.2.4 Meningioangiomatosis
2.2.2.5 Meningeal Meningiomatosis
2.2.3 Clinical Presentation
2.2.3.1 Sites
2.2.3.2 Epidural Meningiomas
2.2.3.3 Meningiomas of the Orbit
2.2.3.4 Meningiomas Involving the Cavernous Sinus
2.2.3.5 Meningiomas in Other Unusual Sites
2.2.3.6 Intracranial Vascular Involvement
2.2.3.7 Peritumoral Edema in Meningiomas
2.2.4 Pretherapeutic Evaluation
2.2.4.1 CT Scanning in Meningiomas
2.2.4.2 MRI Scanning
2.2.4.3 Angiographic Investigation
2.2.4.4 Differential Diagnosis
2.2.5 Therapeutic Strategy and Clinical Objectives
2.2.6 Technical Aspects of Embolization
2.2.7 Special Considerations in Meningioma Embolization
2.2.7.1 Extracranial Tumor Extension
2.2.7.2 Recurrent Meningiomas
2.2.7.3 Internal Carotid Supply to Recurrent or Malignant Meningiomas After Radiation Therapy Has Failed
2.2.7.4 Pial Supply
2.2.7.5 Pre- and Postembolization Medical Management
2.2.7.6 Time of Operation
2.2.7.7 Complications of Embolization
2.3 Other Bony and Dural Tumors
2.3.1 Cerebral Tumors
2.3.2 Neurinomas
2.3.3 Esthesioneuroblastomas

3 Nasopharyngeal Tumors

3.1 Juvenile Angiofibromas
3.1.1 Macroscopic Pathology
3.1.2 Microscopic Pathology
3.1.3 Epidemiology
3.1.4 Pathophysiology
3.1.4.1 Juvenile Angiofibromas and Sex Hormones
3.1.4.2 Physiology and the Nasal Mucosa
3.1.4.3 Hormones and the Vascular System
3.1.4.4 Global Hypothesis for the Development of Juvenile Angiofibromas
3.1.5 Clinical Findings
3.1.6 Natural History
3.1.7 Pretherapeutic Evaluation
3.1.7.1 Computed Tomography
3.1.7.2 Magnetic Resonance Imaging
3.1.7.3 Angiography
3.1.8 Therapeutic Goals
3.1.8.1 Radiation Therapy
3.1.9 Technical Aspects of Embolization
3.1.10 Tumor Recurrence
3.2 Other Nasopharyngeal Tumors
3.3 Conclusion

4 Paragangliomas

4.1 Introduction
4.2 Embryology
4.3 Epidemiology
4.4 Pathology
4.4.1 Vascular Architecture
4.5 Natural History
4.6 Clinical Aspects
4.6.1 Tympanic Paragangliomas
4.6.2 Jugular Paragangliomas
4.6.3 Cervical Paragangliomas
4.6.4 Paragangliomas in Other Locations
4.6.5 Secretory Paragangliomas
4.6.6 Associated Lesions
4.7 Differential Diagnosis
4.8 Pretherapeutic Evaluation
4.8.1 Angiographic Protocol
4.8.2 Temporal Paragangliomas: Specific Features
4.8.3 Cervical Paragangliomas: Specific Features
4.9 Therapeutic Strategies
4.10 Technical Aspects of Embolization
4.11 Complications of Embolization of Paragangliomas

5 Other Head and Neck Tumors

5.1 Thyrolaryngeal Tumors
5.2 Craniofacial Tumors

6 Traumatic Arteriovenous Fistulae

6.1 Introduction
6.2 Traumatic Carotid Cavernous Fistulae
6.2.1 Etiology and Epidemiology
6.2.2 Clinical Aspects of Traumatic Carotid Cavernous Fistulae
6.2.2.1 Ophthalmological Symptoms
6.2.2.2 Corneal Ulcerations and/or Infections and Secondary Glaucoma
6.2.2.3 Diplopia
6.2.2.4 Cranial Nerve Involvementn in Traumatic Carotid Cavernous Fistulae
6.2.2.5 Bruit
6.2.2.6 Arterial Steal
6.2.2.7 Hemispheric Arterial Insufficiency
6.2.2.8 Associated Traumatic Lesions
6.2.3 Pretherapeutic Evaluation
6.2.3.1 Location of the Fistula
6.2.3.2 Venous Drainage of the Fistula
6.2.4 Therapeutic Objectives and Strategy
6.2.4.1 Embolization
6.2.4.2 Emergency Treatment
6.2.4.3 Surgical Approach to Carotid Cavernous Fistulae
6.2.4.4 Conservative Treatment of Traumatic Carotid Cavernous Fistulae
6.2.5 Technical Aspects of Embolization
6.2.5.1 Balloon Selection
6.2.5.2 Manual Compression
6.2.5.3 The Use of NBCA in the Management of Carotid Cavernous Fistulae
6.2.6 Postembolization Care
6.3 Other Traumatic Arteriovenous Fistulae
6.3.1 Extracavernous Arteriovenous Fistulae
6.3.2 Vertebral Arteriovenous Fistulae
6.3.3 Common Carotid Fistulae
6.3.4 External Carotid Fistulae
6.3.5 Malignant Fistulae
6.3.6 Other Epistaxis
6.3.6.1 Coagulopathy
6.3.6.2 Spontaneous Epistaxis
6.3.6.3 Tumoral Epistaxis
6.3.6.4 Biopsy
6.3.6.5 Traumatic Epistaxis

7 Aneurysmal Vasculopathies

7.1 From Aneurysm to Aneurysmal Vasculopathies
7.1.1 General Perspectives
7.1.1.1 Medical Challenge
7.1.1.2 Decision-Making Challenge in Patients with Unruptured Aneurysms
7.1.1.3 Ethical Challenge
7.1.1.4 Academic and Nosological Challenges
7.1.2 Physiopathogenesis and Risks
7.1.2.1 Classification
7.1.3 Segmental Vulnerability
7.1.3.1 Embryological Origin
7.1.3.2 Age of Aneurysms
7.2 Extradural Aneurysms
7.2.1 Introduction
7.2.2 Extradural Internal Carotid Artery Aneurysms
7.2.2.1 Cervical Internal Carotid Aneurysms
7.2.2.2 Acute Spontaneous Dissection of the Carotid Artery
7.2.2.3 Petrous Internal Carotid Artery Aneurysms
7.2.2.4 Aneurysms of the Cavernous Segment of the Internal Carotid Artery
7.2.2.5 Cervical Fibromuscular Dysplasia
7.2.3 Internal Carotid Artery Occlusion in Extradural Internal Carotid Artery Aneurysms
7.2.3.1 Tolerance to Carotid Occlusion
7.2.3.2 Postembolization Care
7.2.4 Extradural Vertebral Aneurysms
7.2.5 Aneurysms of the External Carotid Artery
7.3 Intradural Aneurysms
7.3.1 Saccular Arterial Aneurysms and Associated Diseases
7.3.1.1 Polycystic Kidney Disease
7.3.1.2 Ehlers–Danlos Syndrome
7.3.1.3 Neurofibromatosis Type 1
7.3.1.4 Bourneville Disease
7.3.1.5 Fibromuscular Dysplasia
7.3.2 Saccular Arterial Aneurysms Without Diagnosed Associated Diseases
7.3.2.1 Nonsyndromic Familial Arterial Aneurysms
7.3.2.2 Multiple Saccular Arterial Aneurysms
7.3.2.3 Arterial Anatomy, Single,Mirror, and Twin Saccular Arterial Aneurysms
7.4 Intradural Artery Dissections
7.5 Intradural Giant Saccular and Nonsaccular Arterial Aneurysms
7.5.1 General Remarks
7.5.2 Giant Intracranial Aneurysms with Thrombosis
7.5.3 Nonsaccular Giant Arterial Aneurysms
7.5.3.1 Megadolicho Arteries and Serpentine Arterial Aneurysms
7.5.4 Multiple Giant Arterial Aneurysms and Mirror Giant Arterial Aneurysms
7.6 Infectious, Immune, and Inflammatory Intradural Aneurysms
7.6.1 Infectious Arterial Aneurysms
7.6.2 Intradural Fusiform Aneurysms in Patients with Immune Deficiencies
7.6.3 Inflammatory Diseases and Arterial Aneurysms
7.7 Flow-Related Arterial Aneurysms and Other Aneurysmal Vasculopathies
7.7.1 Intradural Traumatic Arterial Aneurysms
7.7.2 Arterial Aneurysms Associated with Proliferative Diseases
7.7.3 Arterial Aneurysms with Congenital Heart Disorders and Coarctation of the Aorta
7.8 Therapeutic Management
7.8.1 Introduction
7.8.2 Method
7.8.3 Results of the Endovascular Approach
7.8.4 Management of Multiple Arterial Aneurysms
7.8.5 Management of Giant Arterial Aneurysms

8 Dural Arteriovenous Shunts

8.1 Historical Review
8.2 Pathophysiology
8.3 The Osteodural–Venous Complex
8.3.1 Dural Venous Plexus
8.3.2 Transdural Veins
8.4 Classification
8.5 Clinical Presentation of Dural Arteriovenous Shunts
8.5.1 Cranial Nerve Symptoms
8.5.2 Tinnitus and Objective Bruits
8.5.3 Focal Neurological Deficits
8.5.4 Global Neurological Deficits
8.5.5 Intracranial Hemorrhage
8.5.6 Hormonal Influences
8.5.7 Associated Conditions and Multiplicity
8.6 Natural History
8.7 Progression of Symptoms
8.8 Pretherapeutic Evaluation
8.9 Therapeutic Aspects
8.9.1 Indications and Strategy
8.9.2 Topographic Considerations
8.9.3 Technical Aspects
8.9.4 Timing of Embolization
8.9.5 Results of Embolization
8.9.6 Complications of Embolization
8.9.7 Surgery

9 Cerebral Vascular Malformations: Incidence, Classification,Angioarchitecture, and Symptomatology of Brain Arteriovenous and Venous Malformations

9.1 Incidence of Cerebral Vascular Malformations
9.2 Principles of Classification
9.3 Classification of Cerebral Vascular Malformations
9.3.1 Brain Arteriovenous Shunts
9.3.1.1 General Appearance of Arteriovenous Shunts
9.3.1.2 Multiple Brain Arteriovenous Malformations
9.3.1.3 Topographic Analysis of Brain Arteriovenous Malformations
9.3.1.4 Angioarchitecture of Brain Arteriovenous Malformations
9.3.1.5 Clinical–Angioarchitectural Correlation in Brain Arteriovenous Malformations
9.3.2 Venous Variations,Malformations, and Mixed Lesions
9.3.2.1 Developmental Venous Anomalies
9.3.2.2 Cavernous Hemangiomas
9.3.2.3 Cerebral Cavernous Malformations
9.3.2.4 Occult and Cryptic Malformations
9.3.2.5 Sturge–Weber Syndrome

10 Goals and Objectives in the Management of Brain Arteriovenous Malformations

10.1 Introduction
10.2 Indications for Treatment of Brain Arteriovenous Malformations
10.2.1 Age
10.2.2 Sex
10.2.3 Lifestyle and Occupation
10.2.4 Presenting Symptoms
10.2.4.1 Hemorrhage
10.2.4.2 Seizures
10.2.4.3 Headaches
10.2.4.4 Neurological Deficits
10.2.5 Location, Size, and Deep Venous Drainage
10.2.6 Brain Arteriovenous Malformations and Arterial Aneurysms
10.3 Therapeutic Management Strategy
10.4 Embolization
10.4.1 Partial (Targeted) Embolization
10.4.2 Partial (Palliative) Embolization
10.4.3 Curative Embolization
10.4.4 Preoperative Embolization
10.4.5 Intraoperative Embolization Therapy
10.4.6 Embolization Prior to Radiosurgery
10.4.6.1 Size Reduction
10.4.6.2 Targeted Embolization Prior to Stereotactic Radiosurgery
10.4.7 Staging of Embolization
10.4.8 Emergency Embolization
10.4.9 Contraindications for Endovascular Treatment
10.4.10 Embolization Results

11 Spinal Arteriovenous Malformations

11.1 Parachordal Arteriovenous Fistulae (Extracranial, Vertebro-Vertebral, Paraspinal, Extradural, and Extraspinal Arteriovenous Fistulae)
11.1.1 General Remarks
11.1.2 Cranial (Branchial) Arteriovenous Shunts
11.1.2.1 Maxillary Artery-to-Vein Arteriovenous Fistulae (Stapedial)
11.1.2.2 Ascending Pharyngeal-Internal Jugular Arteriovenous Fistulae (Hypoglossal)
11.1.3 Vertebro-Vertebral Arteriovenous Fistulae (Proatlantal and Intersegmental)
11.1.3.1 Vertebro-Vertebral Arteriovenous Fistulae
11.1.3.2 Clinical Findings
11.1.4 Paraspinal Arteriovenous Fistulae
11.2 Spinal Cord Vascular Lesions
11.3 Spinal Cord Arteriovenous Malformations
11.3.1 Classification of Spinal Cord Arteriovenous Malformations
11.3.2 Angioarchitecture
11.3.2.1 Arterial Features
11.3.2.2 Direct Arteriovenous Fistulae
11.3.2.3 High-Flow Angiopathy
11.3.2.4 Arterial Aneurysms in Spinal Cord Arteriovenous Malformations
11.3.2.5 Dural Supply
11.3.2.6 Nidus
11.3.2.7 Veins
11.3.3 Pretherapeutic Evaluation
11.3.3.1 Clinical Assessment
11.3.3.2 Noninvasive Imaging Modalities
11.3.3.3 Angiography
11.4 Spinal Cord Hemodynamics
11.4.1 Particular Forms of Spinal Cord Arteriovenous Malformations
11.4.1.1 Spinal Cord Intradural Arteriovenous Fistulae
11.4.1.2 Spinal Arteriovenous Metameric Syndromes
11.4.1.3 Associated Cerebral and Spinal Arteriovenous Malformations
11.4.2 Clinical Aspects
11.4.2.1 Natural History and Clinical Presentation
11.4.2.2 Prognosis
11.4.2.3 Aggravating Factors
11.5 Treatment of Vascular Lesions
11.5.1 Indications
11.5.2 Results of Spinal Cord Arteriovenous Malformation Embolization
11.5.3 Complications of Embolization
11.5.4 Surgery in the Treatment of Spinal Cord Arteriovenous Malformations
11.5.5 Radiotherapy of Spinal Cord Arteriovenous Malformations
11.5.6 Medical Therapy

12 Spinal Dural Arteriovenous Fistulae

12.1 Pathology
12.1.1 Macroscopic Appearance
12.1.2 Microscopic Appearance
12.1.3 Pathological Changes in the Spinal Cord
12.2 Pathophysiology
12.3 Clinical Presentation of Spinal Dural Arteriovenous Fistulae
12.4 Imaging of Spinal Dural Arteriovenous Fistulae
12.5 Treatment of Spinal Dural Arteriovenous Fistulae
12.5.1 Indications
12.5.2 Embolization of Spinal Dural Arteriovenous Fistulae: Techniques
12.5.3 Results of Spinal Dural Arteriovenous Fistula Embolization
12.5.4 Surgery for Spinal Dural Arteriovenous Fistulae
12.5.5 Postoperative Follow-up

13 Tumors of the Spinal Column and Spinal Cord

13.1 Introduction
13.2 Spinal Angiography
13.3 Angiographic Protocol
13.4 Embolization
13.4.1 Cervical Tumors
13.4.2 Thoracic, Lumbar, and Sacral Tumors
13.4.3 Chemoembolization
13.4.4 Intralesional Embolization
13.5 Benign Tumors
13.5.1 Vertebral Hemangiomas
13.5.1.1 Associated Lesions
13.5.1.2 Pretherapeutic Evaluation
13.5.1.3 Treatment
13.5.1.4 Embolization
13.5.2 Aneurysmal Bone Cysts
13.5.2.1 Clinical Presentation
13.5.2.2 Pretherapeutic Evaluation
13.5.2.3 Angiography
13.5.2.4 Differential Diagnosis
13.5.2.5 Pathogenesis
13.5.3 Other Benign Vascular Tumors
13.5.4 Giant Cell Tumors
13.5.4.1 Pathology
13.5.4.2 Clinical Presentation
13.5.4.3 Radiographic Findings
13.5.4.4 Embolization
13.6 Malignant Tumors
13.6.1 Pretherapeutic Evaluation
13.6.2 Embolization
13.7 Spinal Cord Tumors
13.7.1 Hemangioblastomas
13.7.1.1 Histopathology
13.7.1.2 von Hippel-Lindau Disease
13.7.2 Pretherapeutic Evaluation of Hemangioblastomas
13.7.2.1 Computerized Tomography
13.7.2.2 Magnetic Resonance Imaging
13.7.2.3 Angiography
13.7.3 Feeding Arteries
13.7.4 Draining Veins
13.7.5 Treatment and Embolization
13.8 Other Intradural Vascular Tumors and Spinal Hemorrhage

14 Technical Aspects of Surgical Neuroangiography

14.1 Introduction
14.2 Patient Preparation
14.2.1 Angiographic Equipment
14.2.2 Preoperative Medications
14.2.2.1 Corticosteroids
14.2.2.2 Anticonvulsants
14.2.2.3 Antiplatelets
14.3 Anesthesia
14.3.1 General Anesthesia
14.3.2 Neuroleptic Analgesia
14.3.3 Tracheostomy
14.3.4 Local Anesthesia
14.3.5 Input and Output Monitoring
14.3.6 Arterial Line and Venous Line
14.3.7 Heparinization
14.3.8 Activated Coagulation Time Monitoring
14.3.9 Functional Evaluation
14.3.9.1 Somatosensory- and Motor-Evoked Potentials
14.3.9.2 Facial Nerve Monitoring
14.3.10 Pharmacological Testing
14.3.10.1 Amobarbital
14.3.10.2 Xylocaine
14.3.10.3 Mucocutaneous Territories
14.4 Arteriotomy Sites
14.4.1 Introducer Sheath
14.4.2 Closure Devices
14.4.2.1 Hemostasis of the Arteriotomy Site Closure
14.4.2.2 Internal Closure Devices
14.5 Catheters and Delivery Systems
14.5.1 Guiding Catheters
14.5.2 Microcatheters
14.5.3 Balloon Catheters
14.5.3.1 Tolerance Testing and Flow Control
14.5.3.2 Detachable Balloons
14.5.3.3 Angioplasty Balloon Catheters
14.5.3.4 Balloon-Mounted Stents
14.5.3.5 Stent Delivery Catheters
14.6 Guidewires
14.6.1 Microguidewires
14.7 Embolic Agents
14.7.1 Particulate Agents
14.7.1.1 Absorbable Materials
14.7.1.2 Nonabsorbable Particulate Materials
14.7.1.3 Flow-Directed Particle Embolization
14.7.1.4 General Principles in Aneurysm Treatment
14.7.1.5 General Principles of Coil Treatment of Aneurysms
14.7.2 Nonabsorbable Liquid Agents
14.7.2.1 Introduction
14.7.2.2 Acrylates
14.7.2.3 Sclerotherapy
14.7.2.4 Ethylene-Vinyl Alcohol Copolymer
14.7.3 EVOH in Brain Arteriovenous Malformation Treatment 1089
14.8 Opacifying Agents
14.8.1 Tantalum Powder
14.8.2 Iophendylate (Pantopaque)
14.8.3 Iodized Oil
14.8.4 Ethiodol
14.9 Chemotherapy
14.9.1 Intra-arterial Infusions
14.9.2 Time-Released Microcapsules (Chemoembolization)
14.10 Miscellaneous
14.10.1 Syringes
14.10.2 Stopcocks and Y-Adapters
14.10.3 Tray Containers
14.10.4 Flushing Solutions
14.10.5 Corticosteroids
14.10.6 Normal Physiology of the External Carotid Arteries
14.11 Flow Control
14.11.1 Introduction
14.11.2 Flow Control in the Craniofacial Area
14.11.2.1 Protection of an Endangered Anastomosis
14.11.2.2 Intralesional Flow Control
14.11.2.3 Occlusive Balloon Flow Reversal
14.11.2.4 Functional Rearrangement of the Supply to a Territory
14.11.2.5 Surgical Flow Control
14.11.3 Flow Control in the Meningeal Arcade and Dural Surfaces
14.11.4 Flow Control in the Cerebral Circulation
14.11.4.1 Distal Catheterization
14.11.4.2 Flow Reversal
14.11.4.3 Flow Arrest
14.11.4.4 Systemic Hypotension
14.11.4.5 Catheter Withdrawal
14.11.5 Spine and Spinal Cord
14.11.5.1 Technical Aspects of Endovascular Treatment in the Spine and Spinal Cord
14.12 Postembolization Care
14.12.1 Head and Neck
14.12.2 Cerebral Arteriovenous Malformations
14.12.3 Intradural Aneurysms
14.12.4 Spinal Arteriovenous Malformations
14.13 Complications of Embolization
14.13.1 Complications of Head and Neck Embolization
14.13.1.1 Neurological Deficit
14.13.1.2 Cranial Nerve Deficit
14.13.1.3 Postoperative Swelling
14.13.1.4 Skin Necrosis
14.13.2 Complications of Cerebral Embolization
14.13.2.1 Medical Therapy for Acute Ischemic Stroke
14.13.2.2 Recanalization
14.13.2.3 Microcirculation Agents
14.13.2.4 Antiplatelets
14.13.2.5 Anticoagulation
14.13.2.6 Biorheological Factors
14.13.2.7 Antiedema and Pharmacological Protection Agents
14.13.2.8 Additional Measures
14.13.3 Hemorrhage
14.13.3.1 Generalities
14.13.3.2 Brain Arteriovenous Malformation Rupture
14.13.3.3 Aneurysm Rupture
14.13.3.4 Arterial Stenosis
14.13.3.5 Vasospasm
14.14 Follow-up
14.15 Combined Endovascular Treatments
14.15.1 Combined Endovascular Treatment in Aneurysm Therapy
14.15.2 Combined Endovascular Treatment in Brain Arteriovenous Malformation Therapy
14.15.3 Combined Endovascular Treatment in Occlusive and Hemorrhagic Vascular Disease
14.16 Techniques of Carotid Angioplasty and Stenting
14.16.1 Introduction
14.16.2 Hemodynamic Disturbances During Stenting
14.16.3 Premedication
14.16.4 Vasoactive Medications
14.16.5 Intervention
14.16.6 Predilatation Angioplasty
14.16.7 Stent Selection
14.16.7.1 Self-Expandable Stents
14.16.7.2 Nitinol
14.16.7.3 Balloon-Expandable Stents
14.16.7.4 Low-Profile Balloon-Expandable Stents
14.16.7.5 GFX II
14.16.8 Postdilatation Angioplasty
14.16.8.1 Distal Cerebral Protection
14.16.9 Mechanical Revascularization of Totally Occluded Brachiocephalic Vessels
14.16.10 Complications of Mechanical Revascularization
14.16.11 Stent Retrieval
References
Manufacturers