MyMedR

Fulltext Onyx in Brain Arteriovenous Malformation Embolisation

Hashim H, Muda AS, Abdul Aziz A, Abdul Hamid Z

Malays J Med Sci, 2016 Jul;23(4):59-64.

PMID: 27660546 MyJurnal DOI: 10.21315/mjms2016.23.4.8

Embolisation has long been used as an adjunct to surgical resection in the treatment of brain arteriovenous malformation (bAVM). The most commonly used embolic material, n-butylcyanoacrylate glue, requires experience and skill to handle its quick and unpredictable flow and polymerisation. A new liquid embolic agent, ethylene vinyl alcohol copolymer (Onyx), is less adhesive and polymerises slowly, which provides better control for radiologists performing embolisation.

Matched MeSH terms: Embolization, Therapeutic

Fulltext Epidural haemorrhage during embolisation: a rare complication of intra-arterial embolisation of vertebral metastases

Hashim H, Abdul Kadir K

Biomed Imaging Interv J, 2011 Oct;7(4):e26.

PMID: 22279503 MyJurnal DOI: 10.2349/biij.7.4.e26

Pre-operative embolisation of vertebral metastases has been known to effectively devascularise hypervascular vertebral tumours and to reduce intra-operative bleeding. However, the complications that occur during the procedure are rarely reported. This case study attempts to highlight one rare complication, which is epidural tumoural haemorrhage intra-procedure. It may occur due to the fragility of the tumour and presence of neovascularisation. A small arterial dissection may also have occurred due to a slightly higher pressure exerted during injection of embolising agent. Haemostasis was secured via injection of Histoacryl into the area of haemorrhage. The patient was able to undergo the decompression surgery and suffered no direct complication from the haemorrhage.

Matched MeSH terms: Embolization, Therapeutic

Fulltext COBB syndrome treated by staged intravascular embolisation and surgery

Sayuthi S, Moret J, Pany A, Sobri A, Shafie M, Abdullah J

Med J Malaysia, 2006 Jun;61(2):239-41.

PMID: 16898321 MyJurnal

A 28-year old Malay man with evidence of an upper motor neuron cord lesion was diagnosed to have a C7 to T2 spinal arterio-venous malformation and associated cutaneous vascular lesion. He finally agreed for treatment after 5 years of progressive spastic right lower limb weakness leading to inability to mobilize. A two staged intravascular procedure was done followed by surgery with recovery of ASIA impairment scale grade B.

Matched MeSH terms: Embolization, Therapeutic/methods*

Fulltext Appraisal of clinical profile and management of juvenile nasopharyngeal angiofibroma in malaysia

Hassan S, Abdullah J, Abdullah B, Jihan Wd S, Jaafar H, Abdullah S

Malays J Med Sci, 2007 Jan;14(1):18-22.

PMID: 22593647 MyJurnal

Juvenile nasopharyngeal angiofibroma (JNA) is a benign but locally invasive tumour. Patients are usually in their adolescent age and present with epistaxis and nasal blockage. Diagnosis is based on clinical evaluation and the C.T. scan findings. Pre-operative superselective embolisation (SSE) and surgical excision is the treatment of choice. The out patient clinic of ORL-HNS hospital of University Science Malaysia received 25 referrals, all male, majority between 9-13 years of age and few adolescents. Clinically the patients were consistent with symptoms of recurrent epistaxis and nasal blockage. They reported from October 1998 to October 2001 from with in the state of Kelantan and the nearby states of Pahang, Kedah and Terenganu. Diagnosis was mostly made on typical radiological findings and the tumours were classified accordingly into four stages. SSE and surgical excision was carried out in all cases. Regular follow-up helped us to identify early recurrences which were treated with salvage surgery or radiotherapy in one case with extensive intracranial extension. A retrospective review of presenting features, diagnostic difficulties, surgical approaches and its outcome is presented. Maxillary swing procedure performed in three cases as a new surgical option in the management of JNA is also discussed.
Study site: ENT clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia

Matched MeSH terms: Embolization, Therapeutic

Fulltext Late intravascular embolization of a chemo port catheter

Loch A, Singh RV, Abidin IZ, Han CK, Ahmad WA

J Thorac Oncol, 2011 Jul;6(7):1292.

PMID: 21847043 DOI: 10.1097/JTO.0b013e31821f9771

Matched MeSH terms: Embolization, Therapeutic*

Fulltext Multicenter phase II study of sequential radioembolization-sorafenib therapy for inoperable hepatocellular carcinoma

Chow PK, Poon DY, Khin MW, Singh H, Han HS, Goh AS, et al.

PLoS One, 2014;9(3):e90909.

PMID: 24614178 DOI: 10.1371/journal.pone.0090909

The safety and tolerability of sequential radioembolization-sorafenib therapy is unknown. An open-label, single arm, investigator-initiated Phase II study (NCT0071279) was conducted at four Asia-Pacific centers to evaluate the safety and efficacy of sequential radioembolization-sorafenib in patients with hepatocellular carcinoma (HCC) not amenable to curative therapies.

Matched MeSH terms: Embolization, Therapeutic/adverse effects

Fulltext Role of Uterine Artery Embolization in Pseudoaneurysm of Uterine Artery: A Rare Cause of Secondary Postpartum Hemorrhage

Subramaniam S, Nadarajan C, Aziz ME

Cureus, 2018 Feb 23;10(2):e2220.

PMID: 29692958 DOI: 10.7759/cureus.2220

Uterine artery pseudoaneurysm is an uncommon cause of secondary postpartum hemorrhage, although it carries a high mortality rate. The etiology includes vascular trauma during cesarean section, vaginal delivery, curettage or hysterotomy. We present a post-cesarean female who developed delayed hemorrhage and was diagnosed with left uterine artery pseudoaneurysm. Selective transcatheter arterial embolization was performed and the pseudoaneurysm was successfully obliterated. Angiographic embolization is a safe and efficient method of treatment of postpartum hemorrhage due to pseudoaneurysm in hemodynamically stable patients. Thus, it should be considered as a treatment option before opting for surgery in favorable cases.

Matched MeSH terms: Embolization, Therapeutic

Fulltext Spontaneous thrombosis in a post-traumatic splenic pseudo-aneurysm

Suraini, M. S., Bux, S. I.

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):119-123.

MyJurnal

Introduction: Splenic pseudo-aneurysm is an uncommon complication following splenic injury caused by blunt abdominal trauma. Pseudo-aneurysm is usually treated with splenic arterial embolisation. Spontaneous thrombosis of a splenic pseudo-aneurysm can occur but it is rare. Method: We report a case of spontaneous thrombosis in a post-traumatic splenic pseudo-aneurysm. The patient was managed conservatively as he was haemodynamically stable with a repeat CT scan on the 7th day showing a tubular enhancing structure in the upper pole of the spleen demonstrating the same attenuation value .
Conclusion: This case illustrates a spontaneous resolution of splenic pseudo-aneurysm, which is a rare outcome of the condition.

Matched MeSH terms: Embolization, Therapeutic

Fulltext Novel technique using amplatzer AVP I stent in management for giant renal artery pseudoaneurysm

Sarmukh S, Putera MP, Tan KL, Chew LG

Urol Case Rep, 2021 Mar;35:101515.

PMID: 33318942 DOI: 10.1016/j.eucr.2020.101515

Renal artery pseudoaneurysm (RAP) is an uncommon vascular lesion. Early detection and treatment of renal artery pseudoaneurysm is important because it can rupture and lead to life-threatening hemorrhage. Recent advances in endovascular interventions can prevent potentially challenging open surgery. We describe a case 66 year old patient who presented with a painful abdominal lumbar mass. CT scan show a giant renal artery pseudoaneurysm. We discuss management of giant renal artery pseudoaneurysm, both open surgery and endovascular surgery. Endovascular arterial embolization and stent techniques is feasible. However, open surgical treatment remains to be most effective and radical method in emergency setting.

Matched MeSH terms: Embolization, Therapeutic

Transarterial angioembolization versus surgery after failed endoscopic therapy for non-variceal upper gastrointestinal bleeding

Jailani RF, Kosai NR, Yaacob NY, Jarmin R, Sutton P, Harunarrashid H, et al.

Clin Ter, 2014;165(6):294-8.

PMID: 25524184 DOI: 10.7417/CT.2014.1771

BACKGROUND AND OBJECTIVE: To compare the outcome of transarterial angioembolization (TAE) and surgery with endoscopically unmanageable non-variceal hemorrhage of the upper gastrointestinal tract.

MATERIALS AND METHODS: A case note review of all patients treated for non-variceal upper gastrointestinal bleeding from January 2006 till January 2012 was performed.

RESULTS: Fifty-four of 667 patients with non-variceal bleeding did not respond to endoscopic treatment. Nine of the 54 patients had incomplete data, leaving 45 patients in the study; 24 had angiography and another 21 had surgery. The two groups were broadly similar in terms of relevant clinical variables. Nineteen of 24 having angiography had embolisation. Re-bleeding recurred in 8 patients (33%) in the TAE group and 6 patients (28.6%) in the surgery group (p = 0.28). There was no statistically significant difference in post procedural complications (81% vs 62.5%, p = 0.17), 30-day mortality (33% vs 29.1%, p = 0.17 ) units of blood transfused (12.24 vs 8.92, p = 0.177) and mean hospital stay (30.7 vs 22.9 days, p = 0.281) observed in patients undergoing surgery as compared to TAE.

CONCLUSIONS: TAE and surgery have similar outcomes in patients with endoscopically unmanageable non-variceal upper gastrointestinal haemorrhage.

Matched MeSH terms: Embolization, Therapeutic*

Pulmonary embolism following histoacryl glue embolization for a large thigh arteriovenous malformation

Harunarashid H, Lily S, Rozman Z, Azim MI, Das S

Clin Ter, 2012;163(5):393-5.

PMID: 23099967

Arteriovenous malformation (AVM) are commonly congenital in origin. We hereby describe the case of a 24-year-old male who was diagnosed of left thigh intramuscular AVM at the time of 14 years old. The computerized tomography (CT) scan confirmed a large deep seated intramuscular AVM with the size of 20 x 15 cm, with dilated and distended feeding vessel from profunda femoris artery (PFA) and superficial femoral artery (SFA). He also had another AVM near the left supracondylar region adherent to the sciatic nerve. The main AVM lesion was earlier treated with surgical resection and it remained for asymptomatic for next seven years. Following this, the patient presented again to the clinic with recurring swelling, pain and occasional paraesthesia on the same site. He was then managed with a series of embolization (total of 6 attempts) with histoacryl glue. These attempts of embolization were successful. The interesting case of pulmonary embolism due histoacryl glue following embolization of an AVM is described.

Matched MeSH terms: Embolization, Therapeutic/adverse effects*

Fulltext Ophthalmic artery occlusion following neuro-embolization of the external carotid artery, a case report

Loon NW, Gendeh BS, Zakaria R, Hamzah JC, Din NM

BMC Ophthalmol, 2017 Jun 15;17(1):92.

PMID: 28619056 DOI: 10.1186/s12886-017-0490-7

BACKGROUND: Embozene® is a new neuroembolizing microsphere used to reduce intraoperative bleeding for head and neck tumours. We report a case of iatrogenic ophthalmic artery occlusion after Embozene® embolization of the external carotid artery (ECA).

CASE PRESENTATION: A 22-year-old African gentleman presented with left nasal obstruction and epistaxis for 2 years and was diagnosed with nasopharyngeal carcinoma. He subsequently underwent embolization of the maxillary branch of the left ECA using Embozene® Microspheres - 250 μm in size before endoscopic tumour excision to reduce intra-operative bleeding. He complained of sudden painless profound visual loss in the left eye (LE) two hours after embolization. Visual acuity in LE was no light perception. Fundus examination showed pale retina with no cherry red spot. Arterial narrowing and segmentation were seen in all quadrants. A diagnosis of left ophthalmic artery occlusion was made. Despite immediate management including ocular massage and lowering of intraocular pressure, the visual loss remained. Retrospective review of digital subtraction angiogram showed an anastomosis between the left ophthalmic artery and anterior deep temporal artery as a potential route for microspheres migration.

CONCLUSION: Pre-operative angio-architecture understanding and diligent selection of embolic material are helpful in preventing this adverse event. The use of newer agents for embolotherapy may cause migration of embolic material from the external to the internal carotid system leading to ophthalmic artery occlusion and blindness.

Matched MeSH terms: Embolization, Therapeutic/adverse effects*

Fulltext Characteristics and Outcomes of Patients with Anterior Circulation Intracranial Aneurysm Managed with Clipping in Hospital Sungai Buloh

Ab Ghani A, Nayan SA, Kandasamy R, Rosman AK, Ghani AR

Malays J Med Sci, 2016 Nov;23(6):113-117.

PMID: 28090185 MyJurnal DOI: 10.21315/mjms2016.23.6.12

The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1-1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon's preference. This study aims to report the characteristics and outcomes of patients with a clipped anterior circulation aneurysm in Hospital Sungai Buloh.

Matched MeSH terms: Embolization, Therapeutic

Fulltext Pneumonectomy for congenital isolated unilateral pulmonary artery agenesis

Britton J, Sachithanandan A, Srinivasan L, Ghosh S

Med J Malaysia, 2011 Oct;66(4):363-4.

PMID: 22299560 MyJurnal

Unilateral pulmonary artery agenesis (UPAA) is a rare congenital anomaly usually diagnosed in infancy due to associated cardiovascular malformations. We report a rare case of isolated right UPAA that presented atypically in adulthood with massive haemoptysis requiring a pneumonectomy. This case highlights the importance of maintaining a high clinical suspicion, the role of CT angiography and a multi disciplinary approach. Optimal management is often surgical however bronchial artery embolization (BAE) remains a useful adjunct.

Matched MeSH terms: Embolization, Therapeutic

Fulltext Tricks to do a quick successful Bronchial Artery Embolization (BAE) in massive Haemoptysis

Ezamin Abdul Rahim, Ahmad Sobri Muda, Hariati Jamil

Malaysian Journal of Medicine and Health Sciences, 2018;14(3):46-50.

MyJurnal

Bronchial artery embolization (BAE) is the mainstay treatment for massive haemoptysis. Herein we briefly discuss the tips and tricks of super-selective embolization of bronchial artery using N-butyl-2 cyanoacrylate (NBCA). Based on our experience, this technique produces a better resolution and exhibit high non- recurrence rate in the treatment of massive haemoptysis.

Matched MeSH terms: Embolization, Therapeutic

Fulltext The tale of two vessels, vascular complications following a breach of the pelvic inner table due to acetabular screws: a report of two cases

Ayob KA, Merican AM, Sulaiman SH, Hariz Ramli AR

Jt Dis Relat Surg, 2021;32(1):239-244.

PMID: 33463444 DOI: 10.5606/ehc.2021.77862

Injuries to the pelvic vasculature during total hip arthroplasties are rare but have serious consequence. They demand urgent and early identification so that appropriate treatment can be instituted. If the bleeding is severe, cardiovascular compromise occurs intraoperatively and this will alert the surgeon of this possibility during acetabular screw placement. Alternatively, a delay in diagnosis can occur because the bleeding and the injured vessel are in the pelvic cavity and not visualized during the surgery. In this article, we report two cases from our center occurring within a six-month interval that sustained a vascular injury during acetabular drilling for screw placement for cementless cup fixation. Each case had a different vessel injury and different lessons can be learned from these rare injuries. The first case had an injury of the inferior gluteal artery following a breach of the sciatic notch. The vessel was treated with percutaneous embolization. The second case demonstrated a venous injury, following a medial protrusio technique for congenital hip dysplasia and a short anterosuperior screw, transecting the external iliac vein. This was subsequently repaired using an endovascular technique. We conclude the reasons for these vessel injuries after analyzing advanced imaging, discuss measures to avoid vessel injury and detail the minimally invasive method for their treatment.

Matched MeSH terms: Embolization, Therapeutic/methods*

Fulltext The Amplatzer duct occluder: experience in 209 patients

Bilkis AA, Alwi M, Hasri S, Haifa AL, Geetha K, Rehman MA, et al.

J Am Coll Cardiol, 2001 Jan;37(1):258-61.

PMID: 11153748 DOI: 10.1016/s0735-1097(00)01094-9

Objectives: The aim of the study was to assess the safety and efficacy of the Amplatzer ductal occluder (ADO) in transcatheter occlusion of patent ductus arteriosus (PDA).
Background: Transcatheter closure of small to moderate sized PDAs is an established procedure. The ADO is a self-expandable device with a number of salutary features, notably its retrievability, ease of delivery via small 5F to 7F catheters and a range of sizes suitable even for the larger PDAs.
Methods: Between November 1997 and August 1999, the ADO was successfully implanted in 205 of 209 patients with PDA. The inclusion criteria for this device occlusion method were patients with clinical and echocardiographic features of moderate to large PDA, weighing > or =3.5 kg as well as asymptomatic adolescents and adults with PDA measuring > or =5.0 mm on two-dimensional (2D) echocardiogram. Occlusion was achieved via the antegrade venous approach. Follow-up evaluations were performed with 2D echocardiogram, color-flow mapping and Doppler measurement of the descending aorta and left pulmonary artery velocity at 24 h and 1, 3, 6 and 12 months after implantation.
Results: Two hundred and five patients had successful PDA occlusion using this device. The patients were between two months and 50 years (median 1.9) and weighed between 3.4 kg and 63.2 (median 8.4). Infants made up 26% of the total patients. The PDA measured from 1.8 to 12.5 mm (mean 4.9) at the narrowest diameter. Forty-four percent of patients achieved immediate complete occlusion. On color Doppler the closure rates at 24 h and 1 month after implant were 66% and 97%, respectively. At 6 and 12 months all except one patient attained complete occlusion. Device embolization occurred in three patients; in two this was spontaneous, and in the other it was due to catheter manipulation during postimplant hemodynamic measurement. Mild aortic narrowing was seen in an infant.
Conclusions: Patent ductus arteriosus occlusion using ADO is safe and efficacious. It is particularly useful in symptomatic infants and small children with relatively large PDA. Embolization can be minimized by selection of appropriate sized devices, and caution should be exercised in infants <5 kg.

Matched MeSH terms: Embolization, Therapeutic/instrumentation

Fulltext Functional outcome of microsurgical clipping compared to endovascular coiling

Premananda RM, Ramesh N, Hillol KP

Med J Malaysia, 2012 Dec;67(6):585-90.

PMID: 23770950 MyJurnal

Endovascular coiling has been used increasingly as an alternative to neurosurgical clipping for treating subarachnoid hemorrhage secondary to aneurysm rupture. In a retrospective cohort review on the treatment methods of aneurysm rupture in Hospital Kuala Lumpur over the period of five years (2005-2009) a total of 268 patients were treated. These patients were broadly categorized into two groups based on their treatment mode for ruptured aneurysms. Statistical analysis was determined using Chi- Square tests to study these associations. In our study, 67.5% of patients presented with Good World Federation of Neurosurgical Societies (WFNS) grade (WFNS1-2) while 32.5% patients presented with Poor WFNS prior to intervention. In our outcome, it was noted that 60.4% had good functional outcome (mRS grade 0-2) as compared to 39.6% patients who had poor mRS(modified rankin scale) outcome (mRS 3-6). In the good WFNS group, 76% of patients in clipping group had a good mRS outcome while, 86.5% patients in coiling group had good mRS outcome (p=0.114). In poor WFNS presentation, it was noted that in 77.3% patients in clipping group, had poor mRS outcome. Similarly with poor WFNS presentation, 83.3% of patient in coiling group had poor outcome. (p=1.00). Hence when we control the WFNS group, there was no significant association between treatment group (clipping and coiling) and mRS outcome at 6 months. The outcome of patient is determined by initial clinical presentation (WFNS grade) and influenced by requirement of Extraventricular drain (EVD) in presence of hydrocephalus, CSF infection and pneumonia. Therefore the decision regarding treatment option needs to be individualized based on the presentation of the patient.

Matched MeSH terms: Embolization, Therapeutic*

Fulltext Imaging findings of extensive splenic infarction after cyanoacrylate injection for gastric varices--a case report

Chan RS, Vijayananthan A, Kumar G, Hilmi IN

Med J Malaysia, 2012 Aug;67(4):424-5.

PMID: 23082456

Endoscopic injection of N-Butyl-2-cyanoacrylate is a widely accepted treatment for esophagogastric varices. This procedure is commonly associated with minor complications which include transient pyrexia and abdominal discomfort. Serious vascular complications secondary to systemic embolization of cyanoacrylate have rarely been reported. We describe the CT findings of extensive splenic infarction in a patient following cyanoacrylate injection for gastric varices.

Matched MeSH terms: Embolization, Therapeutic/adverse effects*

Type B patent ductus arteriosus

Wong A, Shahboden M, Pauzi W, Ibrahim W

Pediatr Cardiol, 2007 Jan-Feb;28(1):74-5.

PMID: 17318711 DOI: 10.1007/s00246-006-1398-9

Matched MeSH terms: Embolization, Therapeutic*

Displaying publications 1 - 20 of 63 in total