Direct Puncture of the Cavernous Sinus as Alternative Approach to Treat a Dural Arteriovenous Fistula of the Hypoglossal Canal

2019 ◽  
Vol 30 (1) ◽  
pp. 185-188
Author(s):  
Johnni Zamponi Júnior ◽  
Felipe Padovani Trivelato ◽  
Alexandre Cordeiro Ulhôa ◽  
Marco Túlio Rezende
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Direct Puncture ◽  
Hypoglossal Canal ◽  
Alternative Approach

scholarly journals Embolization of a Cavernous Sinus Dural Arteriovenous Fistula with Onyx via Direct Puncture of the Cavernous Sinus through the Superior Orbital Fissure

2009 ◽  
Vol 15 (2) ◽  
pp. 179-184 ◽  
Author(s):  
N. Amiridze ◽  
G. Zoarski ◽  
R. Darwish ◽  
A. Obuchowski ◽  
N. Soloveychic
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Interventional Therapy ◽  
Superior Orbital Fissure ◽  
Direct Puncture ◽  
Ethylene Vinyl Alcohol ◽  
Trigeminocardiac Reflex ◽  
Ocular Symptoms ◽  
Transvenous Approach

Treatment of cavernous sinus dural arteriovenous fistula (CSDAVF) may be challenging. We describe a patient who had presented with progressive ocular symptoms due to CSDAVF requiring urgent interventional therapy. Initial attempts to embolize the fistula utilizing a transvenous approach through the inferior petrosal sinus failed because of difficult anatomy. Successful occlusion of the fistula was subsequently achieved with injection of ethylene vinyl alcohol copolymer, Onyx (EV3 Neurovascular, Irvine, CA, USA), via direct percutaneous puncture of the cavernous sinus through the superior orbital fissure. A brief period of asystole during the initial injection of Onyx may be the result of the trigeminocardiac reflex.

scholarly journals Cavernous sinus dural arteriovenous fistula treated by facial vein direct puncture: Case report and review of the literature

2017 ◽  
Vol 23 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Atsushi Matsumoto ◽  
Masanobu Okauchi ◽  
Atsushi Shindo ◽  
Masahiko Kawanishi ◽  
Takashi Tamiya
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Inferior Petrosal Sinus ◽  
Digital Subtraction ◽  
Transvenous Embolization ◽  
Review Of The Literature ◽  
Direct Puncture ◽  
Facial Vein

Introduction In case of cavernous sinus dural arteriovenous fistula (CSDAVF), transvenous embolization (TVE) of the cavernous sinus (CS) via the inferior petrosal sinus (IPS) is generally performed. However, various approach routes have been reported when the accessibility of the IPS is challenging. We herein report a case of CSDAVF treated by TVE with direct puncture of the facial vein. Case report A 70-year-old woman who suffered from tinnitus, chemosis, diplopia and bruit was referred to our hospital. Digital subtraction angiography (DSA) demonstrated CSDAVF. We initially attempted to perform TVE via the IPS route; however, we could not guide a catheter to the CS because of an anatomical difficulty. Then, we performed percutaneous direct puncture of the dilated facial vein, and successfully treated the patient. Conclusion When navigating microcatheter to the CS is difficult because of an anatomical difficulty of the IPS, direct puncture of the facial vein is a feasible route.

Unique percutaneous direct puncture technique for occlusion of a hypoglossal canal dural arteriovenous fistula

2018 ◽  
Vol 10 (12) ◽  
pp. 1179-1182 ◽  
Author(s):  
Orlando M Diaz ◽  
Maria M Toledo ◽  
John O F Roehm ◽  
Richard P Klucznik ◽  
Ponraj Chinnadurai ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Embolic Agent ◽  
Direct Puncture ◽  
Ethylene Vinyl Alcohol ◽  
Siemens Healthcare ◽  
Hypoglossal Canal ◽  
Liquid Embolic Agent ◽  
Detachable Coils ◽  
Anterior Condylar Vein

PurposeTo report percutaneous transcranial puncture, embolization and occlusion of a very symptomatic hypoglossal canal/anterior condylar vein dural arteriovenous fistula (DAVF) using syngo iGuide navigational software in a patient in whom transarterial and transvenous embolization and surgery had failed.MethodsAfter unsuccessful arterial and venous embolization and surgical treatment of a symptomatic hypoglossal canal DAVF, a 47-year-old man was transferred for further management. With exquisite anatomic detail provided by C-arm cone-beam computed tomography (CBCT) equipment (Artis zee Biplane, Dyna CT VC21H, Siemens Healthcare GmbH, Germany) and syngo iGuide needle guidance navigational software (Siemens Healthcare GmbHy) for planning a safe direct approach, the hypoglossal/anterior condylar vein, the dominant outflow vein of the fistula, was needle punctured percutaneously at the hypoglossal foramen and occluded with ethylene vinyl alcohol copolymer liquid embolic agent (Onyx, Medtronic, Minneapolis, Minnesota, USA) after placing two anchoring platinum coils (Target detachable coils, Stryker Neurovascular, Fremont, California, USA).ResultsAfter a year of progressively severe left eye proptosis, chemosis and increased intraocular pressure, the symptoms quickly subsided after this embolization and the patient was symptom free at his 3-month and later checkups.ConclusionWith guidance and imaging provided by CBCT and syngo iGuide navigational software, an otherwise untreatable DAVF was successfully embolized and obliterated by an aggressive unique percutaneous trans-cranial needle puncture of the dominant outflow vein in the hypoglossal canal.

Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula

2009 ◽  
Vol 19 (6) ◽  
pp. 1443-1449 ◽  
Author(s):  
Andrea Bink ◽  
Joachim Berkefeld ◽  
Marc Lüchtenberg ◽  
Rüdiger Gerlach ◽  
Tobias Neumann-Haefelin ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula

scholarly journals Pontine venous congestion due to dural arteriovenous fistula of the cavernous sinus: Case report and review of the literature

2012 ◽  
Vol 3 (1) ◽  
pp. 53 ◽  
Author(s):  
Takaaki Miyagishima ◽  
Masato Inoue ◽  
Hiroyasu Ohno ◽  
Kanehiro Hasuo ◽  
Tetsuo Hara ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Venous Congestion ◽  
Review Of The Literature

scholarly journals Treatment Strategy Based on Multimodal Management Outcome of Cavernous Sinus Dural Arteriovenous Fistula (CSDAVF)

2011 ◽  
Vol 6 (1) ◽  
pp. 6 ◽  
Author(s):  
Byung Se Choi ◽  
Jee Won Park ◽  
Jong Lim Kim ◽  
Sung Youn Kim ◽  
Yang Shin Park ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Treatment Strategy ◽  
Dural Arteriovenous Fistula ◽  
Multimodal Management

Combined Surgical and Endovascular Access of the Superficial Middle Cerebral Vein to Occlude a High-Grade Cavernous Dural Arteriovenous Fistula: Case Report

Neurosurgery ◽  
2011 ◽  
Vol 69 (2) ◽  
pp. E475-E482 ◽  
Author(s):  
Michael C. Hurley ◽  
Rudy J. Rahme ◽  
Andrew J. Fishman ◽  
H. Hunt Batjer ◽  
Bernard R. Bendok
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Uneventful Recovery ◽  
Cerebral Vein ◽  
High Grade ◽  
Direct Puncture ◽  
Superficial Middle Cerebral Vein ◽  
Endovascular Approach ◽  
Cortical Venous Drainage

Abstract BACKGROUND AND IMPORTANCE: High-grade cavernous sinus (CS) dural arteriovenous fistulae with cortical venous drainage often have a malignant presentation requiring urgent treatment. In the absence of a venous access to the lesion, transarterial embolization can potentially cure these lesions; however, the high concentration of eloquent arterial territories adjacent to the fistula creates a precarious risk of arterial-arterial reflux. In such cases, a combined surgical and endovascular approach may provide the least invasive option. CLINICAL PRESENTATION: We describe a patient presenting with a venous hemorrhagic infarct caused by a high-grade CS dural arteriovenous fistula (Barrow type D caroticocavernous fistula) with isolated drainage via the superficial middle cerebral vein into engorged perisylvian cortical veins. No transfemoral or ophthalmic strategy was angiographically apparent, and the posterior location of the involved CS compartment mitigated a direct puncture. The patient underwent direct puncture of the superficial middle cerebral vein via an orbitozygomatic craniotomy and the CS was catheterized under fluoroscopic guidance. The CS was coil-embolized back into the distal superficial middle cerebral vein with complete obliteration of the fistula. The patient did well with no new deficits and made an uneventful recovery. CONCLUSION: This novel combined open surgical and endovascular approach enables obliteration of a CS dural arteriovenous fistula with isolated cortical venous drainage and avoids the additional manipulation with direct dissection and puncture of the CS itself.

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