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Tawei Ting - One of the best experts on this subject based on the ideXlab platform.
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Anatomic Variation of facial vein in carotid cavernous fistula and trans facial vein embolization
World Neurosurgery, 2015Co-Authors: Michael Muhuo Teng, Fengchi Chang, Tawei TingAbstract:Objective Trans–facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the Anatomic Variation of FVs and our experience of trans-FV embolization of CCFs. Methods Over 6 years, 26 patients (12 men and 14 women; age range 27–72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the Anatomic Variations of FVs and angiographic and clinical outcomes after embolization. Results FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior ( n = 5), inferior ( n = 1), or at the level of the hyoid bone ( n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Conclusions Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, Anatomic Variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
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Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization
World Neurosurgery, 2015Co-Authors: Fengchi Chang, Michael Muhuo Teng, Tawei TingAbstract:Objective Trans–facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the Anatomic Variation of FVs and our experience of trans-FV embolization of CCFs. Methods Over 6 years, 26 patients (12 men and 14 women; age range 27–72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the Anatomic Variations of FVs and angiographic and clinical outcomes after embolization. Results FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior ( n = 5), inferior ( n = 1), or at the level of the hyoid bone ( n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Conclusions Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, Anatomic Variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
Fengchi Chang - One of the best experts on this subject based on the ideXlab platform.
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Anatomic Variation of facial vein in carotid cavernous fistula and trans facial vein embolization
World Neurosurgery, 2015Co-Authors: Michael Muhuo Teng, Fengchi Chang, Tawei TingAbstract:Objective Trans–facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the Anatomic Variation of FVs and our experience of trans-FV embolization of CCFs. Methods Over 6 years, 26 patients (12 men and 14 women; age range 27–72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the Anatomic Variations of FVs and angiographic and clinical outcomes after embolization. Results FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior ( n = 5), inferior ( n = 1), or at the level of the hyoid bone ( n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Conclusions Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, Anatomic Variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
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Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization
World Neurosurgery, 2015Co-Authors: Fengchi Chang, Michael Muhuo Teng, Tawei TingAbstract:Objective Trans–facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the Anatomic Variation of FVs and our experience of trans-FV embolization of CCFs. Methods Over 6 years, 26 patients (12 men and 14 women; age range 27–72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the Anatomic Variations of FVs and angiographic and clinical outcomes after embolization. Results FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior ( n = 5), inferior ( n = 1), or at the level of the hyoid bone ( n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Conclusions Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, Anatomic Variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
Chengchun Chen - One of the best experts on this subject based on the ideXlab platform.
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visualization of Anatomic Variation of the anterior septal vein on susceptibility weighted imaging
PLOS ONE, 2016Co-Authors: Zhengzhen Chen, Huihuang Qiao, Yu Guo, Huizhong Miao, Caiyun Wen, Xindong Wen, Xiaofen Zhang, Xindong Yang, Chengchun ChenAbstract:Background and Purpose Understanding the anatomy of the anterior septal vein (ASV) is critical for minimally invasive procedures to the third ventricle and for assessing lesion size and venous drainage in the anterior cranial fossa. Accordingly, this study evaluated topographic anatomy and Anatomic Variation of the ASV using susceptibility-weighted imaging (SWI). Methods Sixty volunteers were examined using a 3.0T MR system. The diameter of the ASV and distance between bilateral septal points were measured. ASVs were divided into types 1 (only drains frontal lobe) and 2 (drains both frontal lobe and head of the caudate nucleus). We evaluated the ASV-internal cerebral vein (ICV) junction based on its positional relationship with the appearance of a venous angle or a false venous angle and the foramen of Monro. Fused SW and T1-weighted images were used to observe positional relationships between the course of the ASV and the surrounding brain structures. Results The ASV and its small tributaries were clearly visualized in 120 hemispheres (100%). The average diameter of ASVs was 1.05±0.17 mm (range 0.9–1.6 mm). The average distance between bilateral septal points was 2.23±1.03 mm (range 1.3–6.6 mm). The ASV types 1 and 2 were in 77 (64.2%) and 43 (35.8%) hemispheres, respectively. In 83 (69.2%) hemispheres, the ASV-ICV junction was situated at the venous angle and the posterior margin of the foramen of Monro. In 37 (30.8%) hemispheres, the ASV-ICV junction was situated beyond the posterior margin of the foramen of Monro. The average distance between the posteriorly located ASV-ICV junction and the posterior margin of the foramen of Monro was 6.41±3.95 mm (range 2.4–15.9 mm). Conclusion Using SWI, the topographic anatomy and Anatomic Variation of the ASV were clearly demonstrated. Preoperative assessment of Anatomic Variation of the ASV may be advantageous for minimally invasive neurosurgical procedures.
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susceptibility weighted imaging of the Anatomic Variation of thalamostriate vein and its tributaries
PLOS ONE, 2015Co-Authors: Xiaofen Zhang, Xindong Wen, Chuangen Ren, Ming Cai, Chengchun ChenAbstract:Background and Purpose Thalamostriate vein (TSV) is an important tributary of the internal cerebral vein, which mainly drains the basal ganglia and deep medulla. The purpose of this study was to explore the Anatomic Variation and quality of TSV and its smaller tributaries using susceptibility-weighted imaging (SWI). Methods We acquired SWI images in 40 volunteers on a 3.0T MR system using an 8-channel high-resolution phased array coil. The frequencies of the TSV and its tributaries were evaluated. We classified TSV into types I (forming a venous angle) and II (forming a false venous angle). We classified anterior caudate vein (ACV)into types 1 (1 trunk) and 2 (2 trunks) as well as into types A (joiningTSV), B (joining anterior septal vein), and C (joining the angle of both veins). Results The TSV drains the areas of caudate nucleus, internal capsule,lentiform nucleus, external capsule, claustrum, extreme capsule and the white matter of the frontoparietal lobes,except thalamus. The frequencies of the TSV, ACV and transverse caudate vein (ACV) were 92.5%, 87.5% and 63.8%, respectively. We found TSV types I and II in 79.7%, and 20.3% with significantly different constitution ratios (P< 0.05). The most common types of ACV were type 1 (90.0%) and type A (64.3%). Conclusion The complex three-dimensional (3D) venous architecture of TSV and its small tributaries manifests great Variation, with significant and practical implications for neurosurgery.
Michael Muhuo Teng - One of the best experts on this subject based on the ideXlab platform.
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Anatomic Variation of facial vein in carotid cavernous fistula and trans facial vein embolization
World Neurosurgery, 2015Co-Authors: Michael Muhuo Teng, Fengchi Chang, Tawei TingAbstract:Objective Trans–facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the Anatomic Variation of FVs and our experience of trans-FV embolization of CCFs. Methods Over 6 years, 26 patients (12 men and 14 women; age range 27–72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the Anatomic Variations of FVs and angiographic and clinical outcomes after embolization. Results FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior ( n = 5), inferior ( n = 1), or at the level of the hyoid bone ( n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Conclusions Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, Anatomic Variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
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Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization
World Neurosurgery, 2015Co-Authors: Fengchi Chang, Michael Muhuo Teng, Tawei TingAbstract:Objective Trans–facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the Anatomic Variation of FVs and our experience of trans-FV embolization of CCFs. Methods Over 6 years, 26 patients (12 men and 14 women; age range 27–72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the Anatomic Variations of FVs and angiographic and clinical outcomes after embolization. Results FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior ( n = 5), inferior ( n = 1), or at the level of the hyoid bone ( n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinical follow-up time was 18 months. Conclusions Trans-FV embolization is an effective and safe method to manage CCFs with anterior drainage. However, Anatomic Variations of the FV exist, and a careful work-up of fistula venous drainage before trans-FV embolization is essential to reduce erroneous attempts, procedure time, and periprocedural risk.
Nikunj Rashmikant Chauhan - One of the best experts on this subject based on the ideXlab platform.
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The thoracic duct: clinical importance, Anatomic Variation, imaging, and embolization
European Radiology, 2016Co-Authors: Oren W. Johnson, Michael S. Stecker, Nikunj Rashmikant Chauhan, Jeffrey Forris Beecham Chick, Alexandra Holmsen Fairchild, Chieh-min Fan, Timothy P. Killoran, Alisa Suzuki-hanAbstract:The thoracic duct is the body’s largest lymphatic conduit, draining upwards of 75 % of lymphatic fluid and extending from the cisterna chyli to the left jugulovenous angle. While a typical course has been described, it is estimated that it is present in only 40-60% of patients, often complicating already challenging interventional procedures. The lengthy course predisposes the thoracic duct to injury from a variety of iatrogenic disruptions, as well as spontaneous benign and malignant lymphatic obstructions and idiopathic causes. Disruption of the thoracic duct frequently results in chylothoraces, which subsequently cause an immunocompromised state, contribute to nutritional depletion, and impair respiratory function. Although conservative dietary treatments exist, the majority of thoracic duct disruptions require embolization in the interventional suite. This article provides a comprehensive review of the clinical importance of the thoracic duct, relevant Anatomic variants, imaging, and embolization techniques for both diagnostic and interventional radiologists as well as for the general medical practitioner. Key Points • Describe clinical importance, embryologic origin, and typical course of the thoracic duct . • Depict common/lesser-known thoracic duct Anatomic variants and discuss their clinical significance . • Outline the common causes of thoracic duct injury and indications for embolization . • Review the thoracic duct embolization procedure including both pedal and intranodal approaches . • Present and illustrate the success rates and complications associated with the procedure .
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the thoracic duct clinical importance Anatomic Variation imaging and embolization
European Radiology, 2016Co-Authors: Oren W. Johnson, Michael S. Stecker, Nikunj Rashmikant Chauhan, Jeffrey Forris Beecham Chick, Alexandra Holmsen Fairchild, Timothy P. Killoran, Alisa SuzukihanAbstract:The thoracic duct is the body’s largest lymphatic conduit, draining upwards of 75 % of lymphatic fluid and extending from the cisterna chyli to the left jugulovenous angle. While a typical course has been described, it is estimated that it is present in only 40-60% of patients, often complicating already challenging interventional procedures. The lengthy course predisposes the thoracic duct to injury from a variety of iatrogenic disruptions, as well as spontaneous benign and malignant lymphatic obstructions and idiopathic causes. Disruption of the thoracic duct frequently results in chylothoraces, which subsequently cause an immunocompromised state, contribute to nutritional depletion, and impair respiratory function. Although conservative dietary treatments exist, the majority of thoracic duct disruptions require embolization in the interventional suite. This article provides a comprehensive review of the clinical importance of the thoracic duct, relevant Anatomic variants, imaging, and embolization techniques for both diagnostic and interventional radiologists as well as for the general medical practitioner. • Describe clinical importance, embryologic origin, and typical course of the thoracic duct. • Depict common/lesser-known thoracic duct Anatomic variants and discuss their clinical significance. • Outline the common causes of thoracic duct injury and indications for embolization. • Review the thoracic duct embolization procedure including both pedal and intranodal approaches. • Present and illustrate the success rates and complications associated with the procedure.