Gill this is such great news! So happy for you.
I know what you mean about not wanting that angiogram again. I’m not sure the right answer, but I have read about a CT Angiography being used, which is less invasive than the usual Angiography. The Drs we are using insisted on the traditional Angiography for analyzing the AVM. We are not as far along as you wish i could say we were :). Congratulations!!! So So Happy for you
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Hi Mike, thats interesting. Thank you.
What is the difference between a CT Angiography and Angiography and why would one be less invasive over the other?
BTW, there should a diffrence between a Angiography with and without contrast, can somoe elaborate about this as well?
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Congratulations.
I was told by a Dr. that an Angiography often times look angiographically cured and they absolutely are not, but that was said as to embolization procedure (trans-arterial and transvenous approaches), so I’m not sure as to other procedure’s.
It is confusing to me. However, this study talks about using Triple-MRA rather than DSA (Which I think is the typical for pre Gama Knife.) 2 links below to explain better.
Magnetic Resonance Angiography (MRA) | Johns Hopkins Medicine
As I read more, there is also this MRA. Again, I asked our Drs and they only offered the traditional Angiogram. But this seems like some type of alternative.
Magnetic Resonance Angiography (MRA) | Johns Hopkins Medicine
Chaps,
I’ve moved this into a separate discussion.
My understanding of MRA versus a more regular x-ray angiogram is that the MRA is an MRI undertaken with a contrast material injected into the blood stream, whereas a catheter angiogram is undertaken on an x-ray table with the contrast injected locally by guiding the catheter to the area of interest.
With a MRI, the imagery is made up of slices through the body. To interpret an MRI, the doctor or technician flips through many “slices” to build up a picture of the inside of the body. With an MRA, a contrast material is injected into an artery and causes the blood vessels to be illuminated when scanned. With an MRI, this allows the blood vessels to be seen more clearly in each slice.
When using an x-ray table, a contrast material that floods the whole of the body and illuminates all of the blood vessels would mean that illumination is compressed into a 2 dimensional view on the x-ray image. This wouldn’t help with discerning one vessel from the next. So when using an x-ray table, a catheter is used to inject the contrast material at a site close to the area of interest. Images are taken as the contrast illuminates the area of concern. I assume a contrast material is used that fades quite quickly, as often multiple scans are undertaken.
So I think it is the slicing that an MRI does that allows the contrast to be injected almost anywhere because it is the MRI imagery that limits how the vessels are seem.
With an x-ray table, it’s like all of those images are merged into one, so the contrast has to be administered very locally for the picture to show something useful.
It is the using of the catheter that carries greater risk than simply having an injection. The catheter has to be navigated to the relevant part of the body / brain by steering it at each branch of the artery into the correct route. My consultant explained that there is a little bent guide wire that he uses to turn the corners. My assumption is that the catheter and/or the guide wire can tear the vessel wall and lead to a bleed. There can also be complications with the entry point. A simple injection of contrast with an MRI to achieve an MRA does not carry the same risks.
The triple MRA uses three different ways of scanning with an MRI scanner and the article you found is indicating how this was used as a way to map out for gamma knife rather than the usual method, so it sounds novel and not necessarily widely or commonly used.
I’d guess that each doctor or practice is limited in the first case by the equipment that they have. If they don’t have the equipment to offer a certain type of radiotherapy, then they won’t offer that type of radiotherapy. And the other consideration is the skill of the doctor in undertaking either a scan or treatment. If they prefer a certain method and their success stats are based on that method, then it is dice-throwing stuff to get them to do your preferred means rather than theirs!
These are my thoughts, based on my own experience plus reading the Hopkins article above.
Richard
My son also had a CTA before Gamma was n March. I thought he would get a regular angiogram so I was relieved when appointment nurse told me it wasn’t invasive. She explained that it was to put image into gamma computer for accuracy. So yes a CTA is an non invasive angiogram. Not sure if it can be used to confirm the presence or absence of an AVM in your case. Robert father of Daniel AVM survivor
Thats great! Can i ask where you went for treatment?
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Sure @mikenj . It was at Houston Methodist Hospital. If you further information I can send it you directly.
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We have used an MRI as an alternative to an angiogram. we go back and forth and both seem to show us the pervasiveness of the AVM. The MRI with contrast allowed us to see exactly where it sits. my boy, now 23 still has a way to go. So happy for your good news it gives us hope.
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Thank you Ana. Never give up hope. I wish you and your boy good luck and I hope and pray he will be AVM free soon.x
Thank you, and sorry i asked you that once before. Thanks for the reply .
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Not a problem @mikenj ! Here for you .
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