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Transvenous Doppler guidewire sonographic monitoring during treatment of a complex vertebral arteriovenous fistula associated with neurofibromatosis Type 1
Transvenous Doppler guidewire sonographic monitoring during treatment of a complex vertebral arteriovenous fistula associated with neurofibromatosis Type 1 NEURORADIOLOGY Murayama, Y., Usami, S., Abe, T., Hata, Y., Ganaha, F., Massoud, T. F. 1999; 41 (5): 328-333Abstract
A Doppler sonographic guidewire was used to monitor incremental changes in draining vein (DV) flow during endovascular occlusion of a complex vertebral arteriovenous fistula (AVF) in a patient with neurofibromatosis type 1. Transvenous monitoring of average peak velocity (APV) and the maximum-minus-minimum peak velocity (MxPV-MnPV) demonstrated a progression from a highly pulsatile, fast flow before embolization to a nonpulsatile, slow flow indicating a successful occlusion of the AVF (hemodynamic endpoint of treatment). Prior to this, apparent angiographic occlusion of the AVF was thought to signify a successful endpoint; however, persistently elevated values for APV and MxPV-MnPV in the DV signalled the presence of an additional contralateral arterial contribution. Transvenous monitoring of flow velocity appears to be ideally suited to establishing a hemodynamic endpoint of embolotherapy in the presence of complex arteriovenous shunting, as may occur with the vasculopathy of neurofibromatosis.
View details for Web of Science ID 000080530600004
View details for PubMedID 10379588