Endovascular Vein Approach and Direct Puncture Retrograde Vein

Endovascular Vein Approach and Direct Puncture Retrograde Vein

Alexis M. Yakes BM
Director
The Yakes Vascular Malformation Center
Englewood, Colorado
USA
Wayne Yakes, M.D.
• No relevant financial relationship reported
•J Vasc Interv Radiol. 1990;1:89-96.
•Ethanol embolization of arteriovenous
fistulas: a primary mode of therapy.
•Yakes WF, Luethke JM, Merland JJ, Rak KM,
Slater DD, Hollis HW, Parker SH, Casasco A,
Aymard A, Hodes J, et al.
•Department of Radiology, Fitzsimons Army
Medical Center, Aurora, CO 80045-5001.
•First reported in 3 Figures curative Rx of highflow AVMS/AVF via dominant out-flow vein
approach using ETOH/coils.
•Cardiovasc Intervent Radiol 1996;19: 323-8.
•Treatment of high-flow vascular
malformations by venous embolization
aided by flow occlusion techniques.
•Jackson JE, Mansfield AO, Allison DJ.
•Department of Diagnostic Radiology, Royal
Postgraduate Medical School,
Hammersmith Hospital, Du Cane Road,
London W12 OHS, UK.
•Also documented success with venous
approach in 4 patients with high-flow
lesions.
•Korean J Radiol. 2008; 9(3): 258-67
•Peripheral arteriovenous malformations with a
dominant outflow vein: results of ethanol
embolization.
•Cho SK, Do YS, Kim DI, Kim YW, Shin SW, Park KB, Ko
JS, Lee AR, Choo SW, Choo IW.
•Department of Radiology and Center for Imaging
Science, Samsung Medical Center, Sungkyunkwan
University School of Medicine, Seoul, Korea.
•CONCLUSION: Peripheral AVMs with a DOV can be
effectively treated with a high cure rate by the use of
ethanol embolization alone or in conjunction with the
use of coil and/or core-removed guide wire
embolization. Successful in all 19 patients.
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Pre-#1 DSA
Post-#1a: 2 Microcoils & 2 ml ETOH
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Stasis
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Lt T-9 Intercostal artery
6 months F/up
Lt T-10 Intercostal artery
6 months F/up