PMID: 10449081Aug 17, 1999

Transvenous retrograde nidus sclerotherapy under controlled hypotension (TRENSH): a newly proposed treatment for brain arteriovenous malformations--concepts and rationale

T F Massoud, G J Hademenos


An alternative endovascular treatment to conventional transarterial embolization of cerebral arteriovenous malformations (AVMs) is proposed. According to this proposed treatment, selected AVMs could undergo transvenous retrograde nidus sclerotherapy under controlled hypotensive anesthesia (TRENSH). It is hypothesized that TRENSH may provide the means of avoiding delivery of embolic agents via arterial feeders (thus preventing ischemic complications), in addition to a possible more complete permeation of an AVM nidus with a sclerosant than can otherwise be obtained with current agents via arterial feeders. Instead of relying on access to an AVM nidus from the arterial side (with its usual complexity), TRENSH would require retrograde access to the lesion via much larger and anatomically simpler draining veins. Retrograde permeation of the AVM nidus may then be possible with a liquid sclerosant (to effect a "chemical embolization") provided that the arterial inflow is reduced sufficiently by temporary controlled systemic hypotension, with or without the aid of temporary balloon occlusion of the main arterial feeder(s). Retrograde spread of sclerosant within the nidus that falls short of filling arterial feeders and their branches ...Continue Reading


Apr 10, 2015·Current Treatment Options in Neurology·Andreas Hartmann, J P Mohr
Jun 19, 2015·Veterinary Sciences·Jude Amal Raj, Marcus Stoodley
Mar 21, 2020·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Nicholas A TelischakTarik F Massoud
Aug 4, 2009·Acta neurochirurgica·Hans-Jakob Steiger, Daniel Hänggi
Mar 13, 2014·Journal of Neurointerventional Surgery·Mario Martínez-GaldámezAntonio Pérez-Higueras
Oct 2, 2002·Current Treatment Options in Neurology·Glenn D. Graham
Jan 31, 2015·Journal of Neurosurgery. Pediatrics·L RenieriS Mangiafico
Apr 6, 2013·AJNR. American Journal of Neuroradiology·A ConsoliS Mangiafico
Nov 4, 2015·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·K Yu OrlovP O Seleznev
Nov 22, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Vivek YedavalliTarik F Massoud
Mar 12, 2013·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·V M PereiraK O Lovblad
Sep 2, 2014·Neurosurgical Focus·Matthew B PottsHoward A Riina
Nov 15, 2000·Journal of Biomedical Materials Research·T A BeckerT Brandon


Feb 1, 1979·Journal of Neurosurgery·S Mullan
Oct 1, 1979·Journal of Neurosurgery·C B WilsonJ Domingue
Aug 1, 1990·Investigative Radiology·V B Graves, T A Duff
Aug 1, 1988·Anaesthesia and Intensive Care·B J O'Mahony, S N Bolsin
Mar 1, 1988·AJR. American Journal of Roentgenology·S TakebayashiK Matsui
Feb 1, 1988·Neurosurgery·V V HalbachG Hieshima
Feb 1, 1987·Journal of Neurosurgery·F ViñuelaD M Pelz
Sep 1, 1968·Journal of Neurosurgery·J L Pool
Apr 1, 1966·Journal of Neurosurgery·W F McCormick
Jan 1, 1982·Neurological Research·D Parkinson
Aug 4, 1983·The New England Journal of Medicine·C G Drake
Mar 1, 1982·Surgical Neurology·G HieshimaH F Pribram
Dec 1, 1981·Radiology·B A EllmanP C Peters
Oct 1, 1980·Journal of Neurosurgery·H Nornes, A Grip
Dec 1, 1993·Stroke; a Journal of Cerebral Circulation·L H FleischerJ P Mohr
Feb 1, 1993·Journal of Neurosurgery·C B Wilson, G Hieshima
Jun 1, 1996·Stroke; a Journal of Cerebral Circulation·G J Hademenos, T F Massoud
Jul 1, 1996·Journal of Neurosurgery·S MullanR L Macdonald
Jan 1, 1996·Acta neurochirurgica·H KobayashiT Kubota
Mar 1, 1996·Cardiovascular and Interventional Radiology·W F YakesH Odink
Sep 1, 1996·Cardiovascular and Interventional Radiology·J E JacksonD J Allison
Oct 1, 1939·Annals of Surgery·A O Singleton

Related Concepts

Diastolic Blood Pressure
Absence of Sensation
Cerebral Hemisphere Structure (Body Structure)
Dental Occlusion
Hypotension Adverse Event

Trending Feeds


Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Synapse Loss as Therapeutic Target in MS

As we age, the number of synapses present in the human brain starts to decline, but in neurodegenerative diseases this occurs at an accelerated rate. In MS, it has been shown that there is a reduction in synaptic density, which presents a potential target for treatment. Here is the latest research on synapse loss as a therapeutic target in MS.

Artificial Intelligence in Cardiac Imaging

Artificial intelligence (ai) techniques are increasingly applied to cardiovascular (cv) medicine in cardiac imaging analysis. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

Social Learning

Social learning involves learning new behaviors through observation, imitation and modeling. Follow this feed to stay up to date on the latest research.

Cell Atlas of the Human Eye

Constructing a cell atlas of the human eye will require transcriptomic and histologic analysis over the lifespan. This understanding will aid in the study of development and disease. Find the latest research pertaining to the Cell Atlas of the Human Eye here.

Single Cell Chromatin Profiling

Techniques like ATAC-seq and CUT&Tag have the potential to allow single cell profiling of chromatin accessibility, histones, and TFs. This will provide novel insight into cellular heterogeneity and cell states. Discover the latest research on single cell chromatin profiling here.

Genetic Screens in iPSC-derived Brain Cells

Genetic screening is a critical tool that can be employed to define and understand gene function and interaction. This feed focuses on genetic screens conducted using induced pluripotent stem cell (iPSC)-derived brain cells.