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A cerebral arteriovenous malformation is an abnormal connection between the arteries and veins in the brain—specifically, an arteriovenous malformation in the cerebrum.
Veins are blood vessels in the circulatory system of humans and most other animals that carry blood towards the heart. Most veins carry deoxygenated blood from the tissues back to the heart; exceptions are those of the pulmonary and fetal circulations which carry oxygenated blood to the heart. In the systemic circulation, arteries carry oxygenated blood away from the heart, and veins return deoxygenated blood to the heart, in the deep veins.
Angioplasty, also known as balloon angioplasty and percutaneous transluminal angioplasty (PTA), is a minimally invasive endovascular procedure used to widen narrowed or obstructed arteries or veins, typically to treat arterial atherosclerosis. A deflated balloon attached to a catheter is passed over a guide-wire into the narrowed vessel and then inflated to a fixed size. The balloon forces expansion of the blood vessel and the surrounding muscular wall, allowing an improved blood flow. A stent may be inserted at the time of ballooning to ensure the vessel remains open, and the balloon is then deflated and withdrawn. Angioplasty has come to include all manner of vascular interventions that are typically performed percutaneously.
Coronary artery bypass surgery, also known as coronary artery bypass graft, is a surgical procedure to treat coronary artery disease (CAD), the buildup of plaques in the arteries of the heart. It can relieve chest pain caused by CAD, slow the progression of CAD, and increase life expectancy. It aims to bypass narrowings in heart arteries by using arteries or veins harvested from other parts of the body, thus restoring adequate blood supply to the previously ischemic heart.
An intracranial aneurysm, also known as a cerebral aneurysm, is a cerebrovascular disorder in which weakness in the wall of a cerebral artery or vein causes a localized dilation or ballooning of the blood vessel.
An aneurysm is an outward bulging, likened to a bubble or balloon, caused by a localized, abnormal, weak spot on a blood vessel wall. Aneurysms may be a result of a hereditary condition or an acquired disease. Aneurysms can also be a nidus for clot formation (thrombosis) and embolization. As an aneurysm increases in size, the risk of rupture, which leads to uncontrolled bleeding, increases. Although they may occur in any blood vessel, particularly lethal examples include aneurysms of the circle of Willis in the brain, aortic aneurysms affecting the thoracic aorta, and abdominal aortic aneurysms. Aneurysms can arise in the heart itself following a heart attack, including both ventricular and atrial septal aneurysms. There are congenital atrial septal aneurysms, a rare heart defect.
An anastomosis is a connection or opening between two things that are normally diverging or branching, such as between blood vessels, leaf veins, or streams. Such a connection may be normal or abnormal ; it may be acquired or innate ; and it may be natural or artificial. The reestablishment of an anastomosis that had become blocked is called a reanastomosis. Anastomoses that are abnormal, whether congenital or acquired, are often called fistulas.
In human anatomy, the radial artery is the main artery of the lateral aspect of the forearm.
Cerebral circulation is the movement of blood through a network of cerebral arteries and veins supplying the brain. The rate of cerebral blood flow in an adult human is typically 750 milliliters per minute, or about 15% of cardiac output. Arteries deliver oxygenated blood, glucose and other nutrients to the brain. Veins carry "used or spent" blood back to the heart, to remove carbon dioxide, lactic acid, and other metabolic products. The neurovascular unit regulates cerebral blood flow so that activated neurons can be supplied with energy in the right amount and at the right time. Because the brain would quickly suffer damage from any stoppage in blood supply, the cerebral circulatory system has safeguards including autoregulation of the blood vessels. The failure of these safeguards may result in a stroke. The volume of blood in circulation is called the cerebral blood flow. Sudden intense accelerations change the gravitational forces perceived by bodies and can severely impair cerebral circulation and normal functions to the point of becoming serious life-threatening conditions.
Cerebral angiography is a form of angiography which provides images of blood vessels in and around the brain, thereby allowing detection of abnormalities such as arteriovenous malformations and aneurysms. It was pioneered in 1927 by the Portuguese neurologist Egas Moniz at the University of Lisbon, who also helped develop thorotrast for use in the procedure.
Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes.
Moyamoya disease is a disease in which certain arteries in the brain are constricted. Blood flow is blocked by constriction and blood clots (thrombosis). A collateral circulation develops around the blocked vessels to compensate for the blockage, but the collateral vessels are small, weak, and prone to bleeding, aneurysm and thrombosis. On conventional angiography, these collateral vessels have the appearance of a "puff of smoke".
A vascular bypass is a surgical procedure performed to redirect blood flow from one area to another by reconnecting blood vessels. Often, this is done to bypass around a diseased artery, from an area of normal blood flow to another relatively normal area. It is commonly performed due to inadequate blood flow (ischemia) caused by atherosclerosis, as a part of organ transplantation, or for vascular access in hemodialysis. In general, someone's own vein (autograft) is the preferred graft material for a vascular bypass, but other types of grafts such as polytetrafluoroethylene (Teflon), polyethylene terephthalate (Dacron), or a different person's vein (allograft) are also commonly used. Arteries can also serve as vascular grafts. A surgeon sews the graft to the source and target vessels by hand using surgical suture, creating a surgical anastomosis.
Subclavian steal syndrome (SSS), also called subclavian steal steno-occlusive disease, is a constellation of signs and symptoms that arise from retrograde (reversed) blood flow in the vertebral artery or the internal thoracic artery, due to a proximal stenosis (narrowing) and/or occlusion of the subclavian artery. This flow reversal is called the subclavian steal or subclavian steal phenomenon, regardless of signs/symptoms being present. The arm may be supplied by blood flowing in a retrograde direction down the vertebral artery at the expense of the vertebrobasilar circulation. It is more severe than typical vertebrobasilar insufficiency.
A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an arterial anastomosis is used in vascular bypass and a colonic anastomosis is used to restore colonic continuity after the resection of colon cancer.
A circulatory anastomosis is a connection between two blood vessels, such as between arteries, between veins or between an artery and a vein. Anastomoses between arteries and between veins result in a multitude of arteries and veins, respectively, serving the same volume of tissue. Such anastomoses occur normally in the body in the circulatory system, serving as back-up routes in a collateral circulation that allow blood to flow if one link is blocked or otherwise compromised, but may also occur pathologically.
The leptomeningeal collateral circulation is a network of small blood vessels in the brain that connects branches of the middle, anterior and posterior cerebral arteries, with variation in its precise anatomy between individuals. During a stroke, leptomeningeal collateral vessels allow limited blood flow when other, larger blood vessels provide inadequate blood supply to a part of the brain.
Interventional neuroradiology (INR) also known as neurointerventional surgery (NIS), endovascular therapy (EVT), endovascular neurosurgery, and interventional neurology is a medical subspecialty of neurosurgery, neuroradiology, intervention radiology and neurology specializing in minimally invasive image-based technologies and procedures used in diagnosis and treatment of diseases of the head, neck, and spine.
Saleem Abdulrauf is an American physician specializing in neurosurgery in Washington, DC, who has helped develop high-flow brain bypass surgery, a less invasive procedure for treating intracranial aneurysm than methods used previously.
A flow diverter is an endovascular prosthesis used to treat intracranial aneurysms. It is placed in the aneurysm's parent artery, covering the neck, in order to divert blood flow and determine a progressive thrombosis of the sac. Flow diverting stents consist of structural Cobalt-chrome or Nitinol alloy wires and often a set of radiopaque wires woven together in a flexible braid.
References
- 1 2 Langer, David J.; Vajkoczy, Peter (August 2005). "ELANA: Excimer Laser-Assisted Nonocclusive Anastomosis for extracranial-to-intracranial and intracranial-to-intracranial bypass: a review". Skull Base. 15 (3): 191–205. doi:10.1055/s-2005-872048. ISSN 1531-5010. PMC 1214705 . PMID 16175229.
- ↑ Stecher, D. (March 1, 2021). "Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass". Innovations. 16 (2): 163–168. doi:10.1177/1556984521991519. PMC 8108114 . PMID 33682510.
- ↑ de Boer, B.; van Doormaal, T. P. C.; van Thoor, S.; Gortzak, K.; van der Zwan, A. (February 18, 2020). "Technical Development of the Sutureless ELANA Clip Anastomosis Device". Journal of Medical Devices. 14 (2). doi:10.1115/1.4045801. ISSN 1932-6181. S2CID 213582188.
- ↑ Stecher, David; Hoogewerf, Marieke; Bronkers, Glenn; van Putte, Bart P.; Doevendans, Pieter A.; Tulleken, Cornelis A.F.; van Herwerden, Lex; Pasterkamp, Gerard; Buijsrogge, Marc P. (March 7, 2021). "Preclinical Feasibility and Patency Analyses of a New Distal Coronary Connector: The ELANA Heart Bypass". Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 16 (2): 163–168. doi:10.1177/1556984521991519. ISSN 1556-9845. PMC 8108114 . PMID 33682510.
- ↑ Tulleken, C.A.; Verdaasdonk, R.M.; Beck, R.J.; Mali, W.P. (November 1996). "The Modified Excimer Laser-Assisted High-Flow Bypass Operation". Surgical Neurology. 46 (5): 424–429. doi:10.1016/s0090-3019(96)00096-1. PMID 8874539.
- ↑ Grady, Denise (December 19, 2006). "With Lasers and Daring, Doctors Race to Save a Young Man's Brain". New York Times. p. F1. Retrieved 11 November 2016.