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Neurology India
Medknow Publications on behalf of the Neurological Society of India
ISSN: 0028-3886
EISSN: 0028-3886
Vol. 56, No. 2, 2008, pp. 167-172
Bioline Code: ni08045
Full paper language: English
Document type: Research Article
Document available free of charge

Neurology India, Vol. 56, No. 2, 2008, pp. 167-172

 en Endovascular treatment of scalp cirsoid aneurysms
Gupta, A.K.; Purkayastha, S.; Bodhey, N.K.; Kapilamoorthy, T.R.; Krishnamoorthy, T.; Kesavadas, C. & Thomas, B.

Abstract

Background: Scalp is the most common site of soft tissue arteriovenous fistulae and surgical excision has been the primary mode of treatment. Endovascular treatment has evolved as an alternative to the surgery.
Aims: To evaluate the effectiveness of percutaneous direct-puncture embolization of cirsoid aneurysms.
Materials and Methods: From January 1995 to December 2004, 15 patients underwent percutaneous direct-puncture embolization of cirsoid aneurysms. Plain X-ray, computerized tomography scan and complete selective cerebral angiogram were done in all. Seven patients had forehead lesions, four had temporal and the remaining four patients had occipital region cirsoid aneurysms. Lesions were punctured with 21-gauge needle and embolized with 20-50% cyanoacrylate-lipiodol mixture. Circumferential compression was applied during injection.
Results: Post-embolization angiogram showed complete obliteration in 11 patients. The remaining four patients required adjunctive transarterial embolization with polyvinyl alcohol particles for complete lesion devascularization. Two patients had post procedure surgery for removal of disfiguring and hard glue cast. There were no major procedure-related complications. No patients had any recurrence in the follow-up.
Conclusion: Percutaneous direct puncture embolization of cirsoid aneurysms is a safe and effective procedure. It can be effectively used as an alternative to surgery. Sometimes adjunctive transarterial embolization is also required to deal with deeper feeders.

Keywords
Angiogram, cirsoid aneurysms, embolization, percutaneous direct puncture

 
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