No dia 20 de maio de 2021 o Dr Gelson Luiz Koppe, diretor do ICPR, recebeu sua equipe e ex-fellows para realizar de forma inédita no Brasil o tratamento de um aneurisma cerebral com duas neuroendopróteses Silk Vista Baby (Balt), com uma técnica em “X” (Cross-kissing Technique). É o primeiro cado no Brasil, e o segundo caso a nível mundial utilizando esta técnica, com este dispositivo de última geração.
O procedimento foi realizado no Hospital da Cruz Vermelha, pelo convênio Clinipam.
Foi um prazer participar neste sábado ( 08/05/2021), em Ponta Grossa, de mais um caso de Proctoring com o Dr. Jivago.
É um prazer acompanhar e manter a formação contínua de nossos ex-fellows do programa de Fellowship em Neurorradiologia Intervencionista. Dr. Luiz Penzo e Dr. Gelson Koppe.
Mais um proctor realizado ontem, como parte da formação continuada do nosso programa de Fellowship – Especialização em Neurorradiologia Intervencionista – do ICPR ( Instituto do Cérebro do Paraná). Na foto, o Dr. Gelson Luiz Koppe junto com a Dra Luana Maranha Gatto.
Zeferino Demartini Jr., MD,1–3 Gelson Luis Koppe, MD,2,3
Bernardo Corrêa de Almeida Teixeira, MD,4
Adriano Keijiro Maeda, MD, MSc,1,3
Alexandre Novicki Francisco, MD, MSc,2,3 and Luana Antunes Maranha Gatto, MD, MSc3
1
Department of Neurosurgery, Complexo Hospital de Clinicas, Universidade Federal do Paraná—UFPR; 2
Department of
Neurosurgery, Hospital Pequeno Principe; 3
Department of Neurosurgery, Cajuru University Hospital and Pontifical Catholic
University of Paraná, PUCPR; and 4
Department of Radiology, Complexo Hospital de Clinicas, Universidade Federal do Paraná—
UFPR, Curitiba, Paraná, Brazil
OBJECTIVE Cerebral pial arteriovenous fistula (AVF) is a rare vascular malformation and may cause hemorrhage and
neurological deficit. The presence of high-flow shunts constitutes a challenge when performing the endovascular tech-
nique, due to risk of distal embolization. The authors report a simple maneuver, adapted from the Matas test, that was
successfully applied to treat a child with two pial AVFs.
METHODS An 8-year-old boy presented with headache and vomiting due to two single-channel high-flow intracerebral
pial AVFs. He was treated with an endovascular approach using brief, gentle compression of the ipsilateral cervical carotid
artery. The temporary flow arrest ensured proper placement of the first coil, allowing definitive obliteration of the shunt.
RESULTS There were no complications with the procedure, and the patient recovered uneventfully. Throughout the
9-month follow-up, the patient experienced a stable neurological condition, with both fistulas occluded and improvement
of local circulation.
CONCLUSIONS This easy-to-perform maneuver allows precise positioning of embolic material into high-flow shunts to
facilitate treatment of pial AVF.
https://thejns.org/doi/abs/10.3171/2020.7.PEDS20401
KEYWORDS arteriovenous fistula; cerebrovascular disorders; child; endovascular procedures; intracranial
arteriovenous malformations; therapeutic embolization; surgical technique; vascular disorders
Veja o artigo completo aqui: JNSproof
Initial misdiagnosis of subarachnoid hemorrhage (SAH) in adults may reach up to 51% of the cases and has serious consequences: 65% of delayed diagnosed aneurysmal SAH suffer rebleeding [8, 10]. It results in severe disability or death for most of patients and represents a major source of malpractice litigation [8, 10]. In pediatric population, the diagnosis of intracranial aneurysms (IA) may be missed even after detection of SAH. We describe an atypical case of aneurysm misdiagnosed as traumatic brain injury (TBI).
Veja o artigo completo aqui: 2021-Demartini_CNS_DelayedDiagnosisOfIntracranial-compactado
É amanhã, no Espacio Silan – Webinar (12/03/21) ás 14 horas.
Nessa nova edição do Webinar, teremos o Dr. Gelson Koppe e convidados falando sobre: “Embriología de las MAVs cerebrales”.
Acesse o link e veja mais informações: https://us02web.zoom.us/webinar/register/6915953461164/WN_QyOfJVouSUym1oEFRDVWQw?utm_source=email_marketing&utm_admin=107136&utm_medium=email&utm_campaign=ESPACIO_SILAN_Webinar
Introduction: Aneurysmal bone cyst (ABC) is a rare, benign, and expansible bone lesion, occurring mainly in childhood. Although most lesions are located at the metaphysis of long bones, they can also be found in flat bones and spine.
Case Presentation: We report a case of a 16-year-old boy with cervical ABC treated by endovascular embolization. The afferents were occluded as a preoperative preparation for surgery; however, as the patient became asymptomatic after the procedure, the family refused surgery. Image at 1-year follow-up showed reduction and ossification of the lesion.
Conclusion: Endovascular treatment decreases surgical morbidity by reducing blood loss, which is particularly important in the pediatric population. This therapeutic option may also halt ABC growth in selected cases.
Click and read the full article here.
A 9-month-old male infant with an enlarged left lower limb associated with port-wine stain over the left leg and buttock was diagnosed as Klippel-Trenaunay syndrome (KTS). He presented with progressive weakness in the lower limbs, evolving to paraplegia. Imaging studies showed arteriovenous malformation in the scrotum and high-flow fistulas in the left lower limb and spine, with ectatic veins and venous aneurysm compressing the spinal cord as shown in Figure 1. These imaging findings were consistent with Parkes-Weber syndrome (PWS), distinct from KTS [1]. KTS features consist of port-wine stain (capillary malformations) and varicose veins, associated with soft tissue and bone hypertrophy affecting lower limb in 95% of the cases; in addition, KTS is usually associated with low-flow lesions secondary to mutation of the AGGF1 gene, with relatively good prognosis[1–3]. In contrast, PWS results from mutations in RASA1 gene, which produces high-flow arteriovenous fistulas
with consequent worse prognosis than KTS [3, 4]. Whereas only KTS is associated with limb hypertrophy, similar
features of cutaneous stain may be found in several vascular anomalies, including KTS, Cobb syndrome, SturgeWeber syndrome, and capillary malformation-arteriovenous malformation [2].
Click and read the full article here.
Está aberta consulta pública para incorporação no SUS: participe e ajude a validar esse tratamento no sistema de saúde público brasileiro.
A trombectomia mecânica já é validada por 9 estudos multicentricos como recomendação absoluta para tratamento de AVC isquêmico grave por reduzir sequela e óbito.
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