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Delayed Venous Drainage in Ruptured Arteriovenous Malformations Based on Quantitative Color-Coded Digital Subtraction Angiography

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机构: [1]Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA; [2]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurosurg, Beijing, Peoples R China; [3]Univ Calif San Francisco, Ctr Cerebrovasc Res, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA; [4]Univ Calif San Francisco, Dept Radiol & Biomed Imaging, Div Neurointervent Radiol, San Francisco, CA 94143 USA
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关键词: Arteriovenous malformation AVM Hemodynamics Mean transit time Ruptured AVM Unruptured AVM

摘要:
OBJECTIVE: Clinically applicable hemodynamic risk factors to predict arteriovenous malformation (AVM) rupture are missing in the literature. The aim of this study was to use catheter angiography to identify hemodynamic parameters in ruptured and unruptured AVMs. METHODS: Patients with frontal and temporal AVMs and Siemens syngo iFlow color-coding angiography were included in this study (n = 71). Clinical and radiologic data (age, sex, Spetzler-Martin [SM] and supplemented SM grade, and rupture status), and hemodynamic features (contrast mean transit time [MTT] of feeding arteries, draining veins, AVM nidus, and the cerebral circulation time [CCT]) were analyzed. Univariable analysis was performed to compare findings between ruptured and unruptured AVMs. RESULTS: In total, 35 ruptured and 36 unruptured AVMs were analyzed. Clinical characteristics and AVM grades were comparable between ruptured and unruptured AVMs. Ipsilateral CCT (5.2 vs. 4.0 seconds; P = 0.035), MTT between Tmax of the ipsilateral internal carotid artery and Tmax of sinus entry of the draining vein (3.2 vs. 2.0 seconds; P < 0.001), and MTT between Tmax at the start of venous outflow and Tmax of sinus entry (1.6 vs. 0.7 seconds; P < 0.0001) were significantly longer in ruptured compared with unruptured AVMs. MTTs of nidus, between the internal carotid and feeding arteries, of the venous sinus passage as well as contralateral CCT and controlled ipsilateral CCT were comparable between both groups. CONCLUSIONS: Ruptured AVMs have significantly prolonged venous drainage times compared with unruptured AVMs; this suggests restricted AVM drainage and increased blood pressure within the AVM nidus. Prospective studies are needed to determine the predictive power of these measurements.

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出版当年[2016]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 3 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2015]版:
Q1 SURGERY Q2 CLINICAL NEUROLOGY
最新[2023]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA;
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通讯机构: [1]Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA; [3]Univ Calif San Francisco, Ctr Cerebrovasc Res, Dept Anesthesia & Perioperat Care, San Francisco, CA 94143 USA;
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