indigo-carmine and Arteriovenous-Malformations

Rich and complicated vascular structures on the spinal cord often interfere with obliteration of a spinal arteriovenous malformation (AVM). Vascular orientation during spinal AVM surgery is essential. The authors recently performed six consecutive spinal AVM surgeries in five patients (two with perimedullary AVMs, and three with dural arteriovenous fistulae) with the aid of intra-arterial injection of dye (indigo carmine).. Two representative cases are described. A microcatheter was placed preoperatively in the artery of interest. Subsequent to the exposure of the vascular complex, a 1-ml injection of indigo carmine (2 mg/ml) clearly demonstrated the feeding arteries and the draining veins around the AVM or dural arteriovenous fistula.. One patient had repeat surgery because of incomplete obliteration of the AVM owing to migration of the catheter. All patients, except one who had temporary postoperative deterioration and persistent neurological deficits, had good surgical outcomes, however. No apparent side effects caused by the dye were reported.. The assistance system for spinal AVM surgery is easy and safe and can be applied in other surgical institutions.

Topics: Angiography; Arteriovenous Malformations; Coloring Agents; Humans; Indigo Carmine; Injections, Intra-Arterial; Male; Middle Aged; Postoperative Complications; Spinal Cord; Treatment Outcome

Arteriovenous malformations, submucosal vascular lakes, of the jejunum and ileum which cause chronic gastrointestinal bleeding and anemia are easily identified before operation by selective arteriography but difficult at operation owing to lack of physical signs. This report is concerned with a patient who had such a lesion located in the proximal jejunum. The involved segment was easily identified at operation by injection of Indigo Carmine solution during operation into the involved jejunal artery subselectively catheterized immediately prior to operation. The duration of jejunal staining before resection was 45 minutes in this case and varied from 35 to 55 minutes in five other patients who had right colectomy for carcinoma, providing the opportunity to inject accurately in a conveniently located radiology suite before operation. Safe, convenient, longer periods of staining which could be performed at the time of original diagnosis were demonstrated in dog experiments using "biologic" colloidal carbon in which the bowel segment was well stained at the time of sacrifice five days after injection. There were no gross or microscopic signs of injury to bowel.

Topics: Aged; Angiography; Arteriovenous Malformations; Cecal Neoplasms; Colectomy; Female; Humans; Ileum; Indigo Carmine; Indoles; Jejunum