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Certain cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) are difficult to access through transarterial or transvenous routes and may necessitate access through direct transorbital puncture of the superior ophthalmic vein (SOV) or the CS. However, to be successful, the accurate design of the puncture route and guidance are crucial. This study aimed to report our preliminary clinical experience using cone-beam computed tomography (CT) with real-time fluoroscopic overlays for image guidance during transorbital needle puncture. Between December 2017 and July 2018, 3 patients with CS DAVFs were treated via a transorbital puncture to establish access to the CS under the guidance of XperGuide planning software either via direct CS puncture or through the SOV. The guidance trajectory was superimposed onto the real-time fluoroscopic image during needle puncture. Once access was established, the CS DAVFs were treated with a combination of liquid embolic materials and coils. Image guidance aided to avoid at-risk structures and treatment resulted in all cases in complete obliteration of the CS DAVFs as verified by control angiography without peri- or postprocedural complications. Endovascular embolization of CS DAVFs via direct transorbital puncture aided by image guidance provided an alternative option when more conventional approaches are deemed not possible. [ABSTRACT FROM AUTHOR]

Background Giant serpentine aneurysms (GSAs) are a subgroup of giant intracranial aneurysms, distinct from saccular and fusiform varieties, that are defined as partially thrombosed giant aneurysms with tortuous internal vascular channel. Clinicopathologic characteristics of middle cerebral artery GSAs have been rarely reported in the literature, with discussion of radiologic characteristics only. We clarify patient clinical and neuroradiologic features and discuss the mechanism of formation and progression. Case Description A 43-year-old woman presented with a GSA arising from the middle cerebral artery. There was a separate inflow and outflow channel of the aneurysm, with the outflow channel feeding the distal branches of the parent artery and supplying normal brain parenchyma. The GSA was treated successfully by aneurysmectomy and superficial temporal artery–middle cerebral artery bypass followed by proximal occlusion and vascular reconstruction. An aneurysm specimen was examined to correlate pathologic findings and morphologic characteristics. Result Pathologic results showed that thickness of the aneurysmal wall was typically increased and varied, and no internal elastic lamina or endothelial lining could be identified. The sac contained thrombi of various ages with recanalizing vessel formation and chronic inflammation infiltration. Intimal hyperplasia and neoangiogenesis in the wall and hyaline degeneration of the media were observed. Vessels coursing in their adventitia showed mucoid changes, which are responsible for the contrast enhancement of the aneurysmal rim on computed tomography scan. Conclusions GSAs are a specific pathologic entity with unique morphologic and pathologic characteristics that can affect intracranial blood vessels. The pathogenic mechanisms are unclear; this report suggests that GSAs may be associated with degeneration of the vascular wall. [ABSTRACT FROM AUTHOR]

[Display omitted] • A three-dimensional Eu-MOF with excellent thermal and water stability is successfully synthesized. • The characteristic fluorescence of Eu3+ can be effectively restored by anthrax markers (DPA). • The ratiometric fluorescence sensor shows excellent sensitivity, outstanding selectivity, and superior accuracy for detection of anthrax markers. • Combined with density functional theory and a variety of other analytical methods, the detection mechanism of DPA by Eu-MOF is investigated in detail. Sensitive, efficient and rapid detection of 2, 6-pyridinedicarboxylic acid (DPA), commonly labeled as the main biology marker for bacillus anthracis, is of far-reaching consequence to eliminate potential threats. In this work, a 3D Eu-MOF ([Eu(DHBDC) 1.5 (DMF) 2 ·DMF) that has outstanding thermal and water stability was synthesized. The Eu-MOF showed characteristic fluorescence at 506 nm caused by ligand π-π* transition. The quantum calculation showed that there was a large energy difference between the 5D 0 level of Eu3+ and the triplet energy level of 2,5-dihydroxy terephthalic acid ligand (DHBDC2-), which was why the coordination compound did not exhibit the characteristic fluorescence of Eu3+. Interestingly, it effectively restored the red fluorescence of Eu3+ (593, 618 and 699 nm) and showed a dual-emission fluorescence response at 506 and 593 nm when the DPA existed. Therefore, based on the high detection sensitivity of Eu-MOF (the detection limit is 1.3 μM) and outstanding anti-interference ability, it is expected to become a prospective ratiometric fluorescence sensor for the detection of DPA. In addition, combined with density functional theory (DFT) and a variety of other analytical methods, the detection mechanism of DPA by Eu-MOF was investigated in detail. [ABSTRACT FROM AUTHOR]