Superselective 3D digital subtraction angiography and magnetic resonance fusion imaging for the management of micro-arteriovenous malformations - 20/04/23

Doi : 10.1016/j.neurad.2023.02.005

Alexandru Dimancea ^⁎ , Hugo Trebern, Nader Sourour
Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France

^⁎Corresponding author at: Dr. Alexandru Dimancea, Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, 75013, Paris, France.Alexandru DimanceaDepartment of Interventional NeuroradiologyPitié-Salpêtrière Hospital47, Bd de l'HôpitalParis75013France
Stéphanie Lenck
Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
Sorbonne Université, Paris, France
Inserm UMR 1127, Paris Brain Institute, Paris, France

Frédéric Clarençon
Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
Sorbonne Université, Paris, France

Eimad Shotar
Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France

Abstract

Cerebral micro-arteriovenous malformations (AVM) are defined by an infracentimetric nidus or a nidus solely visible on superselective digital subtraction angiography (DSA).^{1Perrini P., Scollato A., Cellerini M., e al. Results of surgical and endovascular treatment of intracranial micro-arteriovenous malformations with emphasis on superselective angiography Acta Neurochir. (Wien) 2004 ; 146 (8) : 755-76610.1007/s00701-004-0268-6

Cliccare qui per andare alla sezione Riferimenti}^{2Alen J.F., Lagares A., Paredes I., Campollo J., Navia P., Ramos A. Cerebral microarteriovenous malformations: a series of 28 cases J. Neurosurg 2013 ; 119 (3) : 594-6022013.4.JNS121740 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti} While representing a minority of brain AVMs, intracerebral hemorrhage is a frequent manifestation in this subset of AMVs.^{2Alen J.F., Lagares A., Paredes I., Campollo J., Navia P., Ramos A. Cerebral microarteriovenous malformations: a series of 28 cases J. Neurosurg 2013 ; 119 (3) : 594-6022013.4.JNS121740 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti} Micro-AVMs are often occult lesions, with superselective DSA being instrumental for increasing diagnostic yield.^{1Perrini P., Scollato A., Cellerini M., e al. Results of surgical and endovascular treatment of intracranial micro-arteriovenous malformations with emphasis on superselective angiography Acta Neurochir. (Wien) 2004 ; 146 (8) : 755-76610.1007/s00701-004-0268-6

Cliccare qui per andare alla sezione Riferimenti}^{3Tanaka M., Valavanis A. Role of superselective angiography in the detection and endovascular treatment of ruptured occult arteriovenous malformations Interv. Neuroradiol 2001 ; 7 (4) : 303-31010.1177/159101990100700404 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti} While superselective three-dimensional DSA (3D-DSA)/MR fusion imaging has been employed to better delineate anatomical proximity in cerebral AVMs with a visible nidus on MRI,^{4Ide S., Hirai T., Morioka M., e al. Usefulness of 3D dsa-mr fusion imaging in the pretreatment evaluation of brain arteriovenous malformations Acad. Radiol 2012 ; 19 (11) : 1345-135210.1016/j.acra.2012.07.001 [cross-ref]

Cliccare qui per andare alla sezione Riferimenti} this fusion algorithm has not yet been used for describing the relationship of micro-AVMs nidus and afferent arteries with neighboring structures, in order to guide endovascular and microsurgical procedures. In this technical video (Supplementary materials), we present 3 cases regarding micro-AVM embolization, in which superselective 3D-DSA/MR fusion imaging aided therapeutic decision, by defining the local anatomy and allowing a safer procedure.

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Vol 50 - N° 3

P. 366-367 - maggio 2023 Ritorno al numero

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Superselective 3D digital subtraction angiography and magnetic resonance fusion imaging for the management of micro-arteriovenous malformations - 20/04/23

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