AbstractOBJECTIVE:Transcatheter assessment of changes in draining vein (DV) flow velocity has been proposed recently as a potentially useful procedure for hemodynamic monitoring of the progression of embolotherapy in cerebral arteriovenous malformations (AVMs). We compared and contrasted changes in hemodynamic parameters of arterial feeders (AFs) and DVs during experimental AVM embolotherapy.METHODS:Carotid-jugular fistula-type AVM models were surgically created in eight swine. Pre- and postembolization transcatheter mean AF and DV pressures, DV-time average spectral peak velocity, and AF and DV pulsatility indices were assessed. An expression, the peak systolic velocity minus end-diastolic velocity (Vs - Ved), was also used in evaluating the transvenous Doppler spectra. Pre- and postembolization hemodynamic parameters were compared statistically.RESULTS:Pre-embolization DV flow was pulsatile (Vs - Ved, 12 ± 4.8 cm/s), with a mean DV velocity of 39.3 ± 11.4 cm per second. Postembolization, this changed to a less/nonpulsatile pattern (Vs - Vcd, 5.4 ± 2.7 cm/s; P = 0.0035) with a lower mean DV-average spectral peak velocity of 7.0 ± 3.1 cm per second (P = 0.0001). The mean DV pressure was also reduced from 52.0 ± 8.2 to 45.5 ± 8.7 mm Hg (P = 0.0023). The mean AF pressure increased from a mean of 79.5 ± 15.5 to 96.8 ± 16.2 mm Hg (P = 0.0004). The DV pulsatility index values also increased from a mean of 0.3 ± 0.2 to 1.1 ± 0.5 (P = 0.0003). Periembolization objective hemodynamic changes were detected in the DVs earlier than were the visually subjective angiographic changes observed within the nidus.CONCLUSION:This preliminary study indicates that transvenous assessment of average spectral peak velocity and wave pattern (Vs - Ved) may be useful in the hemodynamic evaluation of AVM shunting. The convergence of these two parameters to a range less than 10 cm per second after nidus embolization may afford a theoretical advantage over AF pressure measurements when used for objective and quantitative monitoring of endovascular embolotherapy.
Neurosurgery – Oxford University Press
Published: Jul 1, 1998
It’s your single place to instantly
discover and read the research
that matters to you.
Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.
All for just $49/month
Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly
Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.
Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.
Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.
All the latest content is available, no embargo periods.
“Hi guys, I cannot tell you how much I love this resource. Incredible. I really believe you've hit the nail on the head with this site in regards to solving the research-purchase issue.”Daniel C.
“Whoa! It’s like Spotify but for academic articles.”@Phil_Robichaud
“I must say, @deepdyve is a fabulous solution to the independent researcher's problem of #access to #information.”@deepthiw
“My last article couldn't be possible without the platform @deepdyve that makes journal papers cheaper.”@JoseServera