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Fengchi Chang - One of the best experts on this subject based on the ideXlab platform.

  • anatomic variation of facial vein in carotid cavernous Fistula and trans facial vein embolization
    World Neurosurgery, 2015
    Co-Authors: Michael Muhuo Teng, Fengchi Chang, Tawei Ting
    Abstract:

    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.

  • Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization
    World Neurosurgery, 2015
    Co-Authors: Fengchi Chang, Michael Muhuo Teng, Tawei Ting
    Abstract:

    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.

Tawei Ting - One of the best experts on this subject based on the ideXlab platform.

  • anatomic variation of facial vein in carotid cavernous Fistula and trans facial vein embolization
    World Neurosurgery, 2015
    Co-Authors: Michael Muhuo Teng, Fengchi Chang, Tawei Ting
    Abstract:

    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.

  • Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization
    World Neurosurgery, 2015
    Co-Authors: Fengchi Chang, Michael Muhuo Teng, Tawei Ting
    Abstract:

    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.

Michael Muhuo Teng - One of the best experts on this subject based on the ideXlab platform.

  • anatomic variation of facial vein in carotid cavernous Fistula and trans facial vein embolization
    World Neurosurgery, 2015
    Co-Authors: Michael Muhuo Teng, Fengchi Chang, Tawei Ting
    Abstract:

    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.

  • Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization
    World Neurosurgery, 2015
    Co-Authors: Fengchi Chang, Michael Muhuo Teng, Tawei Ting
    Abstract:

    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.

  • Brainstem edema: an unusual complication of carotid cavernous Fistula.
    American Journal of Neuroradiology, 1991
    Co-Authors: Michael Muhuo Teng, Tsuen Chang, C N Chang, C I Huang, C C Chen, R G Pang
    Abstract:

    Recently, we encountered two cases of carotid cavernous Fistula with the unusual complication of brainstem edema. Both patients had direct-type carotid cavernous Fistulas, which occurred after head injury

Cliff J. Whigham - One of the best experts on this subject based on the ideXlab platform.

  • Endovascular Therapy of Traumatic Vascular Lesions of the Head and Neck
    CardioVascular and Interventional Radiology, 2003
    Co-Authors: Orlando Diaz-daza, Francisco J. Arraiza, John M. Barkley, Cliff J. Whigham
    Abstract:

    Pseudoaneurysm and Fistula formation are well-documented complications of arterial vascular injury and may be associated with significant morbidity and mortality. The purpose of this manuscript is to review the presentation and therapy of patients with traumatic vascular injuries of the head and neck. Eight patients were admitted to a Level 1 Trauma Center and diagnostic angiography of the carotid artery and vertebral circulation was performed. The mechanisms of injury included motor vehicle accident, gunshot wound, stab wound and aggravated assault. Cause of trauma, vascular lesion, endovascular therapy and outcome were analyzed retrospectively. The angiographic findings, clinical presentation and hospital course were reviewed. There were eight patients, seven males and one female, aged 17–65. Four patients (50%) had multiple lesions; four had pseudoaneurysms, two with Fistula formation and two with active arterial hemorrhage. A total of 17 lesions were embolized using coils, Polyvinyl Alcohol (PVA), Gelfoam or a combination. Two of the 17 lesions received stents. Six of the eight patients remained clinically improved or stable at varying follow-up intervals. One of the four patients who presented with penetrating trauma and neurological deficits had resolution of right hemiplegia at the 8^th month follow-up. One of the four patients who sustained blunt trauma and Carotid-Cavernous Fistula presented with a new pseudoaneurysm at the 2-month post-embolization follow-up. The evolution of diagnostic neuroangiographic techniques provides opportunities for endovascular therapy of traumatic vascular lesions of the head and neck that are minimally invasive, attractive options in selected cases.

Dheeraj Gandhi - One of the best experts on this subject based on the ideXlab platform.

  • micro vascular plug mvp assisted vessel occlusion in neurovascular pathologies technical results and initial clinical experience
    Journal of NeuroInterventional Surgery, 2014
    Co-Authors: Narlin Beaty, Gaurav Jindal, Dheeraj Gandhi
    Abstract:

    Background Deconstructive approaches may be necessary to treat a variety of neurovascular pathologies. Recently, a new device has become available for endovascular arterial occlusion that may have unique applications in neurovascular disease. The Micro Vascular Plug (MVP, Reverse Medical, Irvine, California, USA) has been designed for vessel occlusion through targeted embolization. Purpose To report the results from our initial experience with eight consecutive patients in whom the MVP was used to achieve endovascular occlusion of an artery in the head and neck. Methods Eight consecutive patients treated over a nine-month period were included. The patients’ radiographic and electronic medical records were retrospectively reviewed. Specifically demographic information, clinical indication, site of arterial occlusion, size of MVP, time to vessel occlusion, clinical complications, use of other secondary embolic agents, and clinical outcome were recorded. Follow-up information when available is presented. Results The MVP was used in eight patients for the treatment of neurovascular disease. Indications for treatment included post-traumatic head/neck bleeding (n=3), carotid–cavernous Fistula (1), vertebral–vertebral Fistula (1), giant fusiform vertebral aneurysm (1), stump-emboli after carotid dissection (1), and iatrogenic vertebral artery penetrating injury (1). One device was used in five patients, two in two patients, and one patient with extensive vertebral–vertebral venous Fistula required three plugs to effectively trap the Fistula from proximal and distal aspects. Vessel occlusion was obtained in Conclusions To the best of our knowledge, this is the first series reporting the use of MVP in neurovascular disease. Use of this device may be associated with shorter procedural times and cost savings in comparison with the use of microcoils for vessel occlusion. Our experience shows that MVP can have unique applications in neurovascular pathologies and it complements other occlusive devices.