Pre-op Devascularisation of an Intraventricular Haemangioblastoma

Professor Jeffrey P. Kochan, MD
Associate Professor of Radiology and Neurosurgery, Temple University Hospital Philadelphia, USA

Patient History

  • 22-year-old male with history of two-week diplopia.
  • MRI revealed coincidental finding of large densely hypervascular mass in the fourth ventricle supplied by multiple distal branches of the right posterior-inferior cerrebellar artery (PICA).
  • No other focal neurological findings apparent, other than mild divergent gaze after sedation.
Bead Block Case 4 fig 1

Coronal post-gadolinium

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Sagittal pre-gadolinium

 

Procedure

  • Tumour embolised using Bead Block™ 100-300μm through a microcatheter, advanced distally through a 4Fr vertebral catheter into the left posterior cerebellar artery.
  • Infusion discontinued when normal distal left PICA arterial anatomy was visualised.
  • After embolisation a small residual trunk of vessel was satisfactorily coiled with two .010” liquid platinum microcoils.
  • Post-embolisation angiography showed significant reduction of approximately 80% in tumour neovascularity from each of the PICAs.
  • No change to neurologic examination or dysconjucate gaze post-embolisation.

Outcome

  • Satisfactory embolisation of bilateral PICA supply to an intra-fourth ventricular hypervascular mass.
Bead Block Case 4 fig 3

Pre-embolisation: right vertebral artery

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Pre-embolisation: left vertebral artery

 

Bead Block Case 4 fig 5

Pre-embolisation, lateral view: right vertebral artery

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Pre-embolisation, lateral view: left vertebral artery

 

Bead Block Case 4 fig 5

Post-embolisation: left vertebral artery

Bead Block Case 4 fig 8

Post-embolisation, lateral view: left vertebral artery

Regulatory Notices

Worldwide (excluding USA)

Bead Block™ is CE marked and indicated for the treatment of a variety of hypervascular tumours (including Uterine Fibroids) and arteriovenous malformations (AVMs). Bead Blockā„¢ may not be indicated for the treatment of Uterine Fibroids in your country, please check with your local distributor. For full prescribing information please refer to Bead Block instructions for use.

USA

In the USA and Canada, Bead Block™ is indicated for the treatment of hypervascular tumors and arteriovenous malformations (AVMs). For full prescribing information please refer to Bead Block USA Instructions for use.