The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions
Abstract Background Cervicofacial vascular lesions are one of the most challenging diseases managed by intervention radiologists and specialized surgeons. These lesions were diagnosed to be vascular in origin by other imaging techniques such as Duplex and/or magnetic resonance imaging (MRI). All pat...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2021-03-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
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| Online Access: | https://doi.org/10.1186/s43055-021-00466-5 |
| _version_ | 1818948986882490368 |
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| author | Ahmed Mostafa Mohamed Kassem Alaa Mohamed Fathy Abdel Aziz Mohamed Alnekidy Mohamed Ahmed Morsy Mohamed Mahmoud El Shafei |
| author_facet | Ahmed Mostafa Mohamed Kassem Alaa Mohamed Fathy Abdel Aziz Mohamed Alnekidy Mohamed Ahmed Morsy Mohamed Mahmoud El Shafei |
| author_sort | Ahmed Mostafa Mohamed Kassem |
| collection | DOAJ |
| description | Abstract Background Cervicofacial vascular lesions are one of the most challenging diseases managed by intervention radiologists and specialized surgeons. These lesions were diagnosed to be vascular in origin by other imaging techniques such as Duplex and/or magnetic resonance imaging (MRI). All patients underwent computed tomographic angiography (CTA) to confirm the diagnosis as well as to decide the most effective choice of management based on multidisciplinary team (MDT). Then, Digital subtraction angiography (DSA) was done as it is offering an accurate vascular map for the vascular lesions which is inevitable for successful super-selective endovascular embolization which can be done at same sitting. Small cases of arteriovenous malformations (AVMs) were sufficiently managed by only embolization, whereas cases of adequately embolized large AVMs as well as juvenile nasopharyngeal angiofibroma (JNA) cases were followed by surgery with the advantage of less blood loss and decreasing operation time as well as complications. This prospective study was done to highlight the role of combined CTA and DSA in cervicofacial vascular lesion management. Results Twenty patients were included in our study: 16 patients were males, and 4 were females; 17 of them were under 40 years, and three were above 40 years. Preoperative embolization was done in 12 patients, which were all the cases of JNAs and large AVMs. Four patients were managed by only embolization as a definitive treatment. Complete technical success rate was about 94%, while only 6% (single case) of the partial technical success rate which was due to a very small accessory feeder that could not be catheterized even with repeated trials. Conclusions Combined CTA and DSA is the cornerstone for managing vascular lesions in the cervicofacial region, which necessitates a MDT to decide the most beneficial and least complicated way for management. |
| first_indexed | 2024-12-20T08:55:31Z |
| format | Article |
| id | doaj.art-179f2089ecd44f9792d7937ddd89c4a6 |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-12-20T08:55:31Z |
| publishDate | 2021-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-179f2089ecd44f9792d7937ddd89c4a62022-12-21T19:46:01ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622021-03-015211710.1186/s43055-021-00466-5The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesionsAhmed Mostafa Mohamed Kassem0Alaa Mohamed Fathy1Abdel Aziz Mohamed Alnekidy2Mohamed Ahmed Morsy3Mohamed Mahmoud El Shafei4Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Port-Said UniversityDepartment of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityDepartment of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityDepartment of Maxillofacial and Vascular Surgery, Faculty of dentistry, Alexandria UniversityDepartment of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria UniversityAbstract Background Cervicofacial vascular lesions are one of the most challenging diseases managed by intervention radiologists and specialized surgeons. These lesions were diagnosed to be vascular in origin by other imaging techniques such as Duplex and/or magnetic resonance imaging (MRI). All patients underwent computed tomographic angiography (CTA) to confirm the diagnosis as well as to decide the most effective choice of management based on multidisciplinary team (MDT). Then, Digital subtraction angiography (DSA) was done as it is offering an accurate vascular map for the vascular lesions which is inevitable for successful super-selective endovascular embolization which can be done at same sitting. Small cases of arteriovenous malformations (AVMs) were sufficiently managed by only embolization, whereas cases of adequately embolized large AVMs as well as juvenile nasopharyngeal angiofibroma (JNA) cases were followed by surgery with the advantage of less blood loss and decreasing operation time as well as complications. This prospective study was done to highlight the role of combined CTA and DSA in cervicofacial vascular lesion management. Results Twenty patients were included in our study: 16 patients were males, and 4 were females; 17 of them were under 40 years, and three were above 40 years. Preoperative embolization was done in 12 patients, which were all the cases of JNAs and large AVMs. Four patients were managed by only embolization as a definitive treatment. Complete technical success rate was about 94%, while only 6% (single case) of the partial technical success rate which was due to a very small accessory feeder that could not be catheterized even with repeated trials. Conclusions Combined CTA and DSA is the cornerstone for managing vascular lesions in the cervicofacial region, which necessitates a MDT to decide the most beneficial and least complicated way for management.https://doi.org/10.1186/s43055-021-00466-5Vascular lesionsCTADSAEmbolization |
| spellingShingle | Ahmed Mostafa Mohamed Kassem Alaa Mohamed Fathy Abdel Aziz Mohamed Alnekidy Mohamed Ahmed Morsy Mohamed Mahmoud El Shafei The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions The Egyptian Journal of Radiology and Nuclear Medicine Vascular lesions CTA DSA Embolization |
| title | The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions |
| title_full | The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions |
| title_fullStr | The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions |
| title_full_unstemmed | The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions |
| title_short | The role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico-facial vascular lesions |
| title_sort | role of combined computed tomographic angiography and digital subtraction angiography in the management of cervico facial vascular lesions |
| topic | Vascular lesions CTA DSA Embolization |
| url | https://doi.org/10.1186/s43055-021-00466-5 |
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