• We present our experience with Onyx in the curative embolization of brain cerebral arteriovenous malformations (AVMs). (nih.gov)
  • High rates of total or near-total occlusion of brain AVMs can be achieved with multiple sessions of Onyx embolization with acceptable morbidity and mortality. (nih.gov)
  • Luschka and Virchow originally described arteriovenous malformations (AVMs) in the mid 1800s. (medscape.com)
  • Because of the relatively rare and extremely varied clinical presentations, arteriovenous malformations (AVMs) involving the auriculae are technically challenging clinical entities to diagnose and, ultimately, manage. (ajnr.org)
  • The purpose of our study was to present our initial experience of ethanol embolization in a series of 17 patients with auricular AVMs and assess the interim therapeutic outcomes of this method. (ajnr.org)
  • Ethanol embolization has proved efficacious and safe in the treatment of auricular AVMs and has the potential to be accepted as the primary mode of therapy in the management of these lesions. (ajnr.org)
  • Ateriovenous malformations (AVMs) involving the auriculae are technically challenging clinical entities to diagnose and, ultimately, manage. (ajnr.org)
  • At present, it is widely accepted that, for symptomatic auricular AVMs, complete excision with previous embolization is the treatment of choice. (ajnr.org)
  • However, in the management of auricular AVMs, embolization with the conventional mechanical occlusive embolic agents ( n -butyl-2-cyanoacrylate [ n -BCA], polyvinyl alcohol [PVA], and so on), with no subsequent surgery, is just performed in a palliative fashion in children or in patients who are not psychologically prepared for amputation. (ajnr.org)
  • 1 The ethanol embolization of AVMs has good clinical and radiologic implications, even in the management of brain AVMs. (ajnr.org)
  • AVMs are more likely than other types of vascular malformations to be clinically symptomatic. (medscape.com)
  • Endovascular embolization is an effective treatment option for cerebral arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs). (springer.com)
  • A variety of liquid embolic agents have been and are currently used for embolization of AVMs and DAVFs. (springer.com)
  • For AVMs, endovascular embolization can be performed either alone or in combination with microsurgical resection and radiosurgery. (springer.com)
  • Low-grade arteriovenous malformations (AVMs) associated with multiple flow-related distal anterior cerebral artery (DACA) aneurysms are rare occurrences. (surgicalneurologyint.com)
  • Purpose: Onyx embolization is one of the standard treatments for brain arteriovenous malformations (AVMs) and is a promising method for spinal AVMs as well. (korea.ac.kr)
  • Its advantages have been emphasized, and few complications have been reported with Onyx embolization in spinal AVMs. (korea.ac.kr)
  • Extreme caution is required and dual-lumen balloon catheter could be considered for Onyx embolization in spinal AVMs treatment. (korea.ac.kr)
  • High-output heart failure (HF) due to arteriovenous malformation (AVMs) is an unnoticeable cause for HF and PH. (bvsalud.org)
  • Arteriovenous malformations (AVMs) are an important cause of morbidity and mortality among neurosurgical patients , usually due to hemorrhage, but also because of refractory seizures and focal neurologic deficits. (neurosurgicalatlas.com)
  • Management options for AVMs vary from microsurgery alone or in conjunction with or without adjunctive embolization and/or radiosurgery. (neurosurgicalatlas.com)
  • Arteriovenous malformations (AVMs) are vascular birth defects that have the characteristic of having direct connections between arteries and veins. (irpamf.org)
  • Large, diffuse AVMs are often not curable and embolization is merely palliative. (irpamf.org)
  • Small AVMs, especially those with a single outflow vein, have a high chance of cure with embolization alone. (irpamf.org)
  • Percutaneous selective embolization can obliterate AVMs and has increasingly been used for management. (johnshopkins.edu)
  • We believe their principal finding of high safety when pursuing embolization using Onyx and n-BCA to be both encouraging and reflective of appropriate patient selection for standalone embolization treatment of brain arteriovenous malformations (AVMs). (the-jcen.org)
  • The authors appropriately note that "successful" embolization of AVMs may occur in the context of partial occlusion, occlusion of a ruptured portion of an AVM, or obliteration of an intranidal aneurysm when a definitive cure is not the objective. (the-jcen.org)
  • With clinical evidence for elevated recurrence and regrowth of AVMs following embolization, as well as proposed underlying mechanisms, we firmly believe that study surrounding embolization of AVMs should consider development of AVM recurrence or regrowth as a key endpoint. (the-jcen.org)
  • Hereditary haemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is an autosomal dominant mucocutaneous and visceral vascular dysplasia, characterised by the occurrence of telangiectasia and arteriovenous malformations (AVMs). (bmj.com)
  • Wyburn-Mason syndrome (WMS), also known as Bonnet-Dechaume-Blanc syndrome or retinoencephalofacial angiomatosis, is a rare nonhereditary congenital phakomatosis characterized by arteriovenous malformations (AVMs) of the retina, brain, and, in some cases, facial skin. (medscape.com)
  • It is considered one of the nonhereditary congenital phakomatoses and is characterized by arteriovenous malformations (AVMs) that affect the retina, visual pathways, midbrain, and facial structures. (medscape.com)
  • Venous angiomas are enlarged collections of veins and are the most common type of intracranial vascular malformation. (medscape.com)
  • The principle of endovascular embolization is occlusion of the pathological blood vessels of the underlying vascular malformation using a microcatheter, which is selectively positioned within or proximal to the pathology, by injection of an occlusive substance into these vessels. (springer.com)
  • Vascular malformation embolization is utilized to permanently block blood flow to arteriovenous malformations (AVM) and venous malformations in all parts of the body. (moffitt.org)
  • In young adults and children, a leading cause of stroke is an underlying vascular malformation, or abnormal connections between arteries and veins in the brain's vasculature. (medscape.com)
  • Magnetic resonance imaging showed extensive intraosseous femoral involvement of the vascular malformation, and the canal was deemed to be wide enough for a nail based on the radiograph templates and computed tomography (CT) scan. (ac.ir)
  • Surgery: if the primary options when the vascular malformation can be completely removed whithout causing too much damage. (irpamf.org)
  • Embolization/Sclerotherapy: a procedure in which a material is injected in the abnormal vessels to block blood flow and essentially get rid of the vascular malformation with minimal damage to adjacent tissue. (irpamf.org)
  • We want to make sure the diagnosis is correct and we have not mistaken a tumor for a vascular malformation. (irpamf.org)
  • Can vascular malformation be cure? (irpamf.org)
  • Schmidt D. [Congenital retinocephalic facial vascular malformation syndrome. (medscape.com)
  • This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS_dAVF). (nih.gov)
  • Radiation dose measurements during INR were performed in 332 patients with unruptured aneurysm (URAN), dural arteriovenous fistula (DAVF), and arteriovenous malformation (AVM). (go.jp)
  • The first broadly used copolymer-based embolic agent Onyx benefits from a large amount of available experience and data, which demonstrated its safety and efficacy in the treatment of cerebral vascular malformations, while its drawbacks include temporary loss of visibility during longer injections and artifacts in cross-sectional imaging. (springer.com)
  • As the patient awaited digital subtraction angiography, his Glasgow Coma Scale dropped and he underwent emergency embolization with Onyx. (surgicalneurologyint.com)
  • Here, we report an incidental anterior spinal artery (ASA) occlusion due to Onyx reflux during embolization of a spinal type II AVM. (korea.ac.kr)
  • Results: Onyx embolization was performed gradually from the VA to the deep cervical artery and an unexpected Onyx reflux to the ASA was observed during the latter stage deep cervical artery embolization. (korea.ac.kr)
  • Kim, J, Lee, JB, Cho, TH & Hur, JW 2016, ' Incidental occlusion of anterior spinal artery due to Onyx reflux in embolization of spinal type II arteriovenous malformation ', European Spine Journal , pp. 1-5. (korea.ac.kr)
  • In the present report, a novel technique for the retrieval of microcatheters retained during Onyx embolization of intracranial lesions is described. (bmj.com)
  • Intervention During Onyx 18 embolization of the arteriovenous malformations, Echelon-10 microcatheters became entrapped into the arterial feeders by casts of the Onyx. (bmj.com)
  • Conclusions A novel technique, which may be useful in the removal of retained microcatheters during Onyx embolization of Brain arteriovenous malformations, is presented. (bmj.com)
  • We read with great interest the recent article by Behzadi and colleagues entitled "Comparison of transarterial n-Butyl cyanoacrylate (n-BCA) and Onyx embolization of brain arteriovenous malformations: A single-center 18-year retrospective analysis" [ 2 ]. (the-jcen.org)
  • Urogenital fistulas are a known but uncommon complication of gynaecological surgery, especially those involving a malignant process. (annals.edu.sg)
  • The arteriovenous (AV) shunt is the definitive characteristic of these lesions. (medscape.com)
  • Ten patients had previously undergone ligation of the proximal supplying arteries, incomplete surgical resection, and/or embolization and had their lesions deteriorate. (ajnr.org)
  • Background Brain arteriovenous malformations are vascular lesions that are increasingly being treated with endovascular embolization. (bmj.com)
  • BACKGROUND: Episodic growth due to microvascular proliferations (MVP) has been reported in congenital arteriovenous malformations (AVM), which are normally quiescent lesions composed of mature malformed vessels. (bvsalud.org)
  • Multiple DACA aneurysms are a case of both clinical and anatomical rarity and to avoid complications in the clinical course, one must be judicious about the time spent between symptom onset and embolization. (surgicalneurologyint.com)
  • 10 ] We present an unusual case of a low-grade arteriovenous malformation (AVM) with three associated DACA aneurysms arising from a single feeder to an AVM from the left callosomarginal artery. (surgicalneurologyint.com)
  • Head computed tomography angiogram at the time of presentation revealing a compact arteriovenous malformation in the left frontal lobe and three aneurysms in the distal anterior cerebral artery region. (surgicalneurologyint.com)
  • The Penumbra SMART COIL System is comprised of COMPLEX and WAVE ™ coils designed for framing, filling, and finishing intracranial aneurysms and embolising vascular malformations. (shinsokai.com)
  • He has expertise in embolization of aneurysms and AVM's, carotid stenting/endarterectomy, and intra-arterial chemotherapy. (superdoctors.com)
  • Interventional radiological procedures have increasingly been used in recent years for the treatment of vascular disorders, such as arteriovenous malformation, carotid artery stenosis, intracranial aneurism, or arteriovenous fistula, because of its less morbidity and mortality compared with surgery. (escholarship.org)
  • Beginning as flow-directed embolizations via carotid artery catheterizations (n = 12), newer catheters allowed progression to superselective intracerebral catheterizations (n = 38). (ajnr.org)
  • Inadvertent occlusion of the ophthalmic or central retinal artery during external carotid artery embolization has been reported in 4 cases, 2 - 4 with immediate loss of vision. (jamanetwork.com)
  • Results The Neuron 6 F 0.053 inch inner luminal diameter delivery catheter (Penumbra) was placed in a very distal location within the internal carotid artery, external carotid artery and venous system enabling successful endovascular treatment of the intracranial pathology with no related neurological complications. (bmj.com)
  • The differentiation between so-called adhesive and non-adhesive embolic agents refers to a potential complication of cyanoacrylates, which is the inability to retrieve a microcatheter when its tip is trapped in highly concentrated acrylic glue. (springer.com)
  • A potential complication with endovascular embolization is microcatheter entrapment within the embolic material. (bmj.com)
  • We describe one potential complication of transcatheter embolization that involves necrosis of the bladder wall with a novel technique for endoscopic management of an extruded coil in the bladder. (johnshopkins.edu)
  • Embolization results in cerebral arteriovenous malformations were improved with superselective catheterization and most improved with the combined use of polyvinyl alcohol for nidus embolization followed by occlusion of the feeding vessel with microcoils. (ajnr.org)
  • Immediate postprocedural occlusion rate after transarterial embolization was 30% only. (nih.gov)
  • 1 Complications are rare, but include infarction by unintended occlusion of vessels. (jamanetwork.com)
  • This tumor is the result of a congenital arteriovenous malformation hepatocyte response. (wikipedia.org)
  • A cerebral arteriovenous malformation (AVM) is an abnormal connection between the arteries and veins in the brain that usually forms before birth. (medlineplus.gov)
  • An arteriovenous malformation (AVM) of the brain is an abnormality of the blood vessels that connect arteries and veins, which interferes with the flow of blood and oxygen. (vinmec.com)
  • Arteriovenous malformation (AVM) occurs when arteries and veins become tangled, impeding proper blood flow and circulation. (theveinspecialists.com)
  • Catheter-directed embolization is a non-surgical, outpatient treatment performed by our interventional radiologists using imaging to treat a variety of benign and malignant tumors. (moffitt.org)
  • Pre-surgical embolization - Before a surgeon resects a tumor, they often request our team to embolize these tumors beforehand to minimize blood loss and other complications related to bleeding. (moffitt.org)
  • Therapeutic embolization is an accepted component in the management of vascular tumors, arteriovenous malformations, and active bleeding sites. (jamanetwork.com)
  • Embolization procedures are not limited to the renal system or to benign tumors. (acsh.org)
  • Efficacy was defined as complete angiographic obliteration after the last embolization session. (providence.org)
  • A few hours after the last embolization session, the patient sustained an ischemic complication in the left subcortical white matter. (cd177signaling.com)
  • 1. Jończyk J, Szubert W, Panasiuk M. Pathological subtrochanteric femoral fracture due to extensive arterio‑venous malformation. (ac.ir)
  • 9. Gibbon WW, Pooley J. Pathological fracture of the femoral shaft in a case of Servelle‑Martorell syndrome (phleboeclatic osteohypoplastic angiodysplasia with associated arterio‑venous malformation). (ac.ir)
  • Subrat P., Nalini S., Aisha K. D., Anusmita S., Rituparna D. and Pranjal P. (2021) "Transcatheter Artery Embolization for Postoperative Haemorrhage after Arterio- Venous Malformation - Safer Option", Acta medica Lituanica, 28(1), pp. 159-164. (himsr.co.in)
  • We identified 101 patients who underwent a total of 219 sessions of embolization. (nih.gov)
  • More embolization sessions are to be carried out on the remaining 49 patients. (nih.gov)
  • In the remaining 7 patients, ethanol embolization was decided as the primary treatment method after full review of findings from clinical and imaging examinations of the patients. (ajnr.org)
  • Between September 1985 and June 1989, we performed embolizations in 54 patients with cerebral arteriovenous malformations. (ajnr.org)
  • Predicting which patients are likely to develop these complications is important. (bmj.com)
  • Researchers have identified a genetic mutation in patients with an arteriovenous malformation (AVM) of the brain, a leading cause of hemorrhagic stroke in young adults and children. (medscape.com)
  • Vascular neurosurgeons like himself have been "frustrated" with the lack of management options for some patients with these malformations, he said. (medscape.com)
  • About half of these malformations are identified because patients present with a bleeding episode. (medscape.com)
  • OBJECTIVES: We evaluated the safety and efficacy of endovascular embolization as first-line stand-alone strategy for the treatment of low-grade brain arteriovenous malformations (bAVMs) (Spetzler Martin [SM] grade I and II) in pediatric patients. (providence.org)
  • MATERIAL AND METHODS: We conducted a single center retrospective cohort study of all pediatric (≤18 years) patients who underwent embolization as a stand-alone strategy for low-grade bAVMs between 2010 and 2022. (providence.org)
  • Please note the relevant information for patients suffering from an arteriovenous malformation is presented in another chapter. (neurosurgicalatlas.com)
  • Most pertinent to the present work of Behzadi and colleagues is the increased recurrence rate observed in young patients undergoing curative embolization, with one paper reporting a recurrence rate of over 70% in a cohort with highly-protocolized imaging follow-up and identifying embolization as a predictor of AVM recurrence [ 7 ]. (the-jcen.org)
  • In therapeutic embolization, medical professionals have usurped this power and employed it for the good of the patient in a controlled and constructive fashion. (acsh.org)
  • Transcatheter arterial embolization and/or direct percutaneous puncture embolization were performed. (ajnr.org)
  • Management involves transcatheter embolization with either inert glues, balloons, or fibered titanium coils that are designed to limit the flow through feeding vessels. (johnshopkins.edu)
  • Embolization procedures are designed to use special materials threaded through the vasculature (or bloodstream) and strategically positioned to cut off the blood supply to a cancerous or benign but growing tumor, for example. (acsh.org)
  • The dilated and abnormal retinal vasculature characteristic of a retinal arteriovenous malformation. (medscape.com)
  • This axial T2-weighted MRI shows arteriovenous malformation nidus on the right side. (medscape.com)
  • All the complications were intraoperative nidus ruptures. (providence.org)
  • venous angiomas, a more common type of cerebrovascular malformation, account for 64% of cases. (medscape.com)
  • Spetzler-Martin grades 4 and 3) presented for embolization. (bmj.com)
  • The most common complications were reversible necrosis and blister. (ajnr.org)
  • Although rare, more serious complications involve skin necrosis/ulceration and nontargeted embolization which could cause compromise of the blood flow to other organs. (irpamf.org)
  • Matsuo T, Yanai H, Sugiu K, Tominaga S, Kimata Y. Orbital exenteration after transarterial embolization in a patient with Wyburn-Mason syndrome: pathological findings. (medscape.com)
  • In order to determine possible risk factors and to assess the value of platinum microcoils added to polyvinyl alcohol particles in preoperative embolization of cerebral arteriovenous malformations in adults, we reviewed our experience with this procedure. (ajnr.org)
  • Knowledge of the special properties of the agent which is used is crucial for an effective and safe embolization procedure. (springer.com)
  • The patient was discharged on the 6th post-procedure day without any neurological complications. (escholarship.org)
  • Conclusion Cerebral angiography in adults, children and infants is a safe procedure with low risk of permanent neurological complications. (thieme-connect.de)
  • Prostatic artery embolization is a minimally invasive procedure that helps improve lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH). (moffitt.org)
  • Hemorrhoid embolization - This embolization procedure targets the arteries supplying hemorrhoids and is used to manage bleeding. (moffitt.org)
  • Uterine fibroid embolization - This fertility-sparing procedure uses advanced techniques to block blood flow and oxygen to problematic uterine fibroids, which causes them to shrink and relieve fibroid-related symptoms such as heavy bleeding and pain. (moffitt.org)
  • In addition, we assessed the predictors of procedure-related complications and radiographic complete obliteration in a single session. (providence.org)
  • Safety was measured by procedure-related complications and mortality. (providence.org)
  • Six procedure-related complications (5.8% of procedures) were observed and no deaths were reported. (providence.org)
  • In a statement just released by the office of the First Lady, Melania Trump is recovering well at Walter Reed National Military Medical Center after undergoing a "successful" embolization procedure today without complications for a "benign kidney condition. (acsh.org)
  • What is an embolization procedure? (acsh.org)
  • The clinical course was favorable and the patient was discharged without neurological complications. (escholarship.org)
  • However, the malformation was not completely excised and another fluoroscopically guided superselective angiography followed by surgical removal of the residual malformation was required. (escholarship.org)
  • Therapies include open or laparoscopic surgical resection, arterial embolization, or radio-frequency ablation. (wikipedia.org)
  • Surgical indications or arterial embolization for FNH include if the FNH lesion is large, symptomatic, or there is uncertainty surrounding the correct diagnosis. (wikipedia.org)
  • Brain capillary telangiectasias are slow-flow vascular malformations composed of dilated capillary-like vessels, are classically located in the pons, and are typically benign and discovered incidentally. (medscape.com)
  • An arteriovenous malformation (AVM) is a tangled cluster of vessels, typically located in the supratentorial portion of the brain, in which arteries connect directly to veins without an intervening capillary bed. (medscape.com)
  • We explored metastasis-associated protein 1 (MTA1) promoter methylation in the development of brain arteriovenous malformation (BAVM). (bvsalud.org)
  • Results of their new study suggest that these malformations are a result of KRAS -induced activation of the mitogen-activated protein kinase-extracellular signal-regulated kinase (MAPK-ERK) signaling pathway in brain endothelial cells. (medscape.com)
  • These malformations are difficult to treat because they require complex brain surgery, radiation, endovascular embolization, or a combination of these modalities, said Dr Radovanovic. (medscape.com)
  • A venous-dynamic malformation can develop anywhere in the body but is most commonly found in the brain or spinal cord. (vinmec.com)
  • Embolization as stand-alone strategy for pediatric low-grade brain art" by Aaron Rodriguez-Calienes, Juan Vivanco-Suarez et al. (providence.org)
  • Embolization as stand-alone strategy for pediatric low-grade brain arteriovenous malformations. (providence.org)
  • Ponce FA, Han PP, Spetzler RF, Canady A, Feiz-Erfan I. Associated arteriovenous malformation of the orbit and brain: a case of Wyburn-Mason syndrome without retinal involvement. (medscape.com)
  • There were no complications related to the microcatheter extractions. (bmj.com)
  • Recurrence is generally defined with respect to confirmed angiographic cure, but regrowth after partial treatment with embolization is another endpoint of clinical significance. (the-jcen.org)
  • To further complicate the situation, quite a substantial number of vascular 'malformations' enlarge markedly and cause increased morbidity after birth. (cancernetwork.com)
  • LEAs that are available for the embolization of cerebral vascular malformations can basically be divided into two groups: cyanoacrylates or adhesive embolic agents, which have a glue-like behavior (colloquially they are often named glue) and copolymers or nonadhesive embolic agents, which are described to feature lava-like or rubber-like characteristics. (springer.com)
  • This presumably underreported complication was the initiator for the development of the non-adhesive embolic agent ethylene vinyl alcohol (EVOH or EVAL), which aimed to avoid this issue [ 11 ]. (springer.com)
  • The "Bright Falx" Sign-Midline Embolic Penetration Is Associated With Faster Resolution of Chronic Subdural Hematoma After Middle Meningeal Artery Embolization: A Case Series. (ucla.edu)
  • Preoperative measures to decrease vascularity such as stereotactic radiotherapy and angiographic embolization can be undertaken to reduce bleeding. (ac.ir)
  • There was no postoperative CSF rhinorrhea or complications related to the use of the VCS. (neurosurgery.directory)
  • Besides of postoperative deformities many other risks and complications have to be considered. (egms.de)
  • Some "complications" however are in fact a mistake in preoperative analysis or surgical planning, in applying an inadequate technique or in postoperative care [1] . (egms.de)
  • Pelvic arteriovenous malformation (AVM) is a rare condition in which a section of blood vessels lacks a capillary network, resulting in blood from an artery being delivered directly to a vein. (johnshopkins.edu)
  • They show that the size, severity and symptoms did not predict risk of complications. (bmj.com)
  • The goal of treatment is to prevent further complications by controlling the bleeding and seizures and, if possible, removing the AVM. (medlineplus.gov)
  • Nidal size evaluation is relevant in order to optimize patient selection for embolization as a stand-alone treatment modality. (providence.org)
  • The alternate-day regimen reduces side effects, and, in fact, we have never seen a serious documented long-term complication from this level of treatment. (cancernetwork.com)
  • 2. Ohshika S, Yanagisawa M, Tsushima F, Ishibashi Y. Diagnosis and conservative treatment of a rare case of femoral intraosseous arteriovenous malformation in a patient with polyostotic fibrous dysplasia: A case report. (ac.ir)
  • Successful treatment of pathologic femoral shaft fracture associated with large arteriovenous malformations using a 3‑dimensional external fixator and teriparatide: A case report. (ac.ir)
  • At The Vein Specialists, our highly trained team develops personalized treatment plans to reduce the risk of serious complications. (theveinspecialists.com)
  • Depends on patient's symptom or desire D&C and embolization can also be used as treatment options. (icrjournal.ir)
  • PAVM embolisation reduced ischaemic stroke. (bmj.com)
  • We describe a case of neuroplasticity associated with both arteriovenous malformation (AVM) and stroke, which occurred in two successive events in the same patient. (cd177signaling.com)
  • The goal of part I is to statistically assess the cerebral angiograms, their indications, risks and complications, as well as to do a technical review. (thieme-connect.de)
  • median age 14 years) underwent a total of 102 embolization sessions. (providence.org)
  • Embolization has led to shorter surgical procedures, more clearly defined operative margins, and less bloody operative fields. (ajnr.org)
  • Monitoring of complications after endoscopic skull base surgery is necessary in order to standardize protocols of management and improve our surgical techniques. (neurosurgery.directory)
  • Spontaneous involution of retinal and intracranial arteriovenous malformation in Bonnet-Dechaume-Blanc syndrome. (medscape.com)
  • We found no significant increase in complications based on patient age, venous drainage of the arteriovenous malformation, or the circulation embolized. (ajnr.org)