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Biomedical subjects

V Aletich

Publications and source records attributed to V Aletich.

11 recordsLinked to original sources
PubMed1999

Evaluation and endovascular treatment of juxtaorbital vascular anomalies.

The evaluation of juxtaorbital anomalies with routine imaging, including CT and MR imaging, usually is insufficient for endovascular therapy planning. Cerebral angiography remains crucial to define detail necessary for endovascular therapy. This article provides an overview of the authors' approach and the endovascular therapies available to treat these lesions.

Aneurysm↗
PubMed1999

Direct cervical internal carotid access for GDC treatment of an ophthalmic origin carotid aneurysm.

The use of detachable coils in the treatment of intracranial aneurysms continues to evolve since its introduction in 1991 [1-5]. Although not well described in the literature, technical considerations in gaining and maintaining access to intracranial aneurysms play a pivotal role in any successful endovascular treatment. Tortuosity and looping of the cervical internal carotid artery (ICA) is one problem occasionally encountered. These unusual loops, in addition to the normal turns of the carotid siphon result in less control of the microcatheter tip. This problem culminated in this case where an ophthalmic origin carotid aneurysm could not be successfully treated from the standard femoral approach due to the presence of multiple ICA turns, with the presence of a proximal cervical ICA turn being particularly bothersome. This problem was circumvented by use of direct surgical access to the cervical ICA above the cervical ICA turn, allowing for successful endovascular aneurysm treatment with detachable coils.

Aneurysm↗
PubMed1998

Management of pericentral arteriovenous malformations.

Pericentral arteriovenous malformations (AVMs) have more often been deemed inoperable lesions because of their complexity, owing to their critical locations and dismal outcome. This study discusses the management of this group of patients with a variety of treatments which includes surgery, nidus embolization, and radiosurgery. Out of 89 patients treated for AVMs in our institute over a period of 30 months (1992 through May 1995), we present a case series of 34 patients who had AVMs located in the pericentral region. All the treated AVMs were Spetzler and Martin grade III (6 patients), grade IV (13 patients), and grade V (15 patients). The neurological outcome remained, normal or improved from baseline in 68% of patients following treatments; of the remaining 32%, 19% remained in the same condition (with continuing preoperative deficits) and 10% showed some deterioration from their pretreatment condition. Thus 87% were unchanged or improved after the treatment regime. There was a 3% mortality (one patient who died as result of initial hemorrhage) in the series. Our multimodality treatment for this group of AVMs confirms the efficacy of the practiced strategies for their management. The results derived from the experience with this selected group of patients with AVMs lead us to recommend treating these patients with multimodality regimen rather than awaiting the natural history of the disease in the best interest of the patients.

Adolescent↗
PubMed1997

Embolization of the nidus of brain arteriovenous malformations with n-butyl cyanoacrylate.

OBJECTIVE: To demonstrate that nidus embolization of brain arteriovenous malformations (AVMs) with Histoacryl (B. Braun, Melsungen, Germany) is effective and yields low morbidity and mortality rates. METHODS: We present a retrospective analysis of 54 brain AVMs treated at the University of Illinois at Chicago from April 1994 to December 1995. Treatment modalities included embolization in all cases and then surgical resection or radiosurgery. INSTRUMENTATION: The nidus was reached with the combined use of a Magic microcatheter (Balt, Montmorency, France) and a Terumo 0.010-inch guidewire. TECHNIQUE: Embolization was performed only when the tip of the microcatheter was wedged into the nidus of the AVMs with no reflux of contrast proximally. The embolization was performed using simultaneous biplane roadmapping with the patient under general anesthesia without Amytal testing. RESULTS: Twenty-six of 54 patients are still waiting for more radical treatment. Two deaths and two minor and one severe permanent neurological deficit occurred. Three patients were cured with embolization alone; 11 patients were cured after surgical resection. Three patients underwent radiosurgery, with one cure after 1 year. CONCLUSION: Nidus embolization with Histoacryl is an effective technique that permits complete cure of a large number of brain AVMs, with or without surgical resection and/or radiosurgery.

Adolescent↗
PubMed1996

Transcranial cerebral oximetry in endovascular treatment of carotid-cavernous fistula.

The transcranial cerebral oximeter is a reliable, low-cost, noninvasive device that provides real-time evaluation of regional brain oxygen saturation during endovascular treatment of cerebrovascular diseases. We discuss three patients with carotid-cavernous fistulae treated by endovascular balloon occlusion, each monitored continuously before, during, and after the procedure with transcranial cerebral oximetry. The cerebral oxygen saturation measured was directly related to the side of the venous drainage of the fistula, being 15-20% higher on that side. Following endovascular occlusion of the fistula, oxygen saturation gradually became equal on the two sides.

Adult↗