Interactive Transcript
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This is a companion case to our AVM.
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In this particular case, we only
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needed to do transabdominal.
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We have a bladder full.
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We could see our uterus pretty well.
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And you can see there's a lot of
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heterogeneity up towards the fundus,
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and a lot of color Doppler flow.
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We put a lot of different spectral Dopplers on
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her to try and figure out what was going on.
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This waveform's a bit of a high resistance.
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We got up to 67 centimeters per second.
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As we kept going trying to find these, our
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peak velocities kept getting higher and higher.
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And she was someone who had suffered a
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miscarriage and had continual bleeding
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afterwards and had transvaginal imaging
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showing what looked like an AVM.
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So prior to going to CVIR, we again tried
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to get these peaks to stop velocities to
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see if she would benefit from conservative
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therapy, just watching and waiting.
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But since her velocities were up to the
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200th, we felt that this would not and that
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she was a good candidate for intervention.
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This was actually used, what
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we did here, was a B mode.
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This is not a contrast ultrasound,
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but it does provide pretty neat
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vascular images without contrast.
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And in this particular case, what we
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thought it helped was that our, our
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velocities we were getting early on,
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you couldn't angle correct necessarily.
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We were just sort of guessing.
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You know, there's so much color
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Doppler flow, it's hard to tell exactly
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which way we should put that box.
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But when we did the B flow images, you
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could get a better idea of which way
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that vessel was flowing, so we could
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angle correct a little bit better.
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And that's when we started getting
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these much higher vascular flows,
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which we felt better represented what
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was actually going on in her case.
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Here's a pre-procedural planning CTA.
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And again, just to show you how vascular
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it is, and it's all sort of in the fundus
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and a little bit anterior right here.
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That's what she looked like there.
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All those tangles of vessels.
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Right there.
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And then finally, she went to angio and you
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can again see here this tangle of blood vessels.
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To go back to the beginning of that feels very
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early, but there's a larger kind of cystic
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AVM itself, that larger nidus of the AVM here.
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So she was embolized and did quite well
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after this as well. Her AVM also got much
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smaller in size and all of her velocities
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went down to more normal levels as well.
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