Endovascular Treatment of Sphenoid Wing Dural Arteriovenous Fistula with Pure Cortical Venous Drainage

2014 ◽  
Vol 23 (6) ◽  
pp. 1730-1735 ◽  
Author(s):  
Hitoshi Fukuda ◽  
Kosuke Miyake ◽  
Takenobu Kunieda ◽  
Kenichi Murao
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Cortical Venous Drainage

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.

Endovascular Treatment of an Intracranial Dural Arteriovenous Fistula with Spinal Venous Drainage

1998 ◽  
Vol 4 (3) ◽  
pp. 241-246 ◽  
Author(s):  
R. Cruz ◽  
A. Stocker ◽  
J. Xavier ◽  
J. Almeida-Pinto
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Venous Drainage ◽  
Hyperintense Signal ◽  
Type V ◽  
Progressive Paraparesis ◽  
T2 Weighted Images

A case of type V intracranial dural arteriovenous fistula (DAVF) is reported because of its unusual rapidly progressive paraparesis. Despite this clinical presentation, the diagnosis of DAVF was made and precocious endovascular treatment was instituted. Angiographic normalization was obtained after embolisation and the patient significantly improved within the first weeks, although at the six month control MRI there still was a hyperintense signal of the cord in T2 weighted images, but less extensive than originally.

Endovascular treatment of complex dural arteriovenous fistula using the dual-microcatheter technique

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Michael R. Levitt ◽  
Joshua W. Osbun ◽  
John D. Nerva ◽  
Louis J. Kim
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Jugular Bulb ◽  
Endovascular Embolization ◽  
Venous Hypertension ◽  
Lost To Follow Up ◽  
Onyx Copolymer

A 71-year-old woman presented with headache and dilated vessels on CTA. Angiography demonstrated a complex dural arteriovenous fistula with retrograde cortical venous hypertension, supplied by branches of internal and external carotids bilaterally into a fistulous pouch paralleling the left transverse and sigmoid sinuses, which was occluded at the jugular bulb. The patient refused treatment and was lost to follow-up, returning with sudden confusion and hemianopsia from left temporo-occipital hemorrhage. Transvenous endovascular embolization was performed using the dual-microcatheter technique with a combination of coiling and Onyx copolymer, completely occluding the sinus and fistula while preserving normal venous drainage.The video can be found here: http://youtu.be/u_4Oc7tSmDM.

scholarly journals Endovascular Treatment of a Dural Arteriovenous Fistula of the Transverse Sinus by Recanalisation, Angioplasty and Stent Deployment

2003 ◽  
Vol 9 (1) ◽  
pp. 65-69 ◽  
Author(s):  
W. Weber ◽  
B. Kis ◽  
J. Esser ◽  
P. Berlit ◽  
D. Kühne
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Venous Reflux ◽  
Stent Deployment ◽  
Total Occlusion ◽  
Cortical Venous Reflux

We report the endovascular treatment of a 40-year-old woman with bilaterally thrombosed transverse sinuses and a dural arteriovenous fistula (DAVF) causing cortical venous reflux by recanalization, angioplasty and stent deployment of the occluded sinus segment followed by occlusion of the DAVF by stent deployment in the fistulous segment. By recanalization of the occluded sinus we re-established normal anterograde venous drainage and eliminated the venous hypertension and cortical venous reflux. After the procedure, the patient was treated with aspirin and clopidogrel for three months. A follow-up examination showed total occlusion of the DAVF, patency of the sinus and a complete resolution of the clinical symptoms.

scholarly journals Dural arteriovenous fistula in the sphenoid bone lesser wing region: Endovascular adjuvant techniques of treatment and literature review

2018 ◽  
Vol 24 (5) ◽  
pp. 559-566 ◽  
Author(s):  
Dmitriy V Kandyba ◽  
Konstantin N Babichev ◽  
Artem V Stanishevskiy ◽  
Arevik A Abramyan ◽  
Dmytriy V Svistov
Keyword(s):  
Literature Review ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Sphenoid Bone ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
The Given ◽  
Balloon Protection

This article describes the successful endovascular treatment of a dural arteriovenous fistula of a rare localization (the area of sphenoid bone lesser region). We examine one report of an unusually located dural arteriovenous fistula successfully treated with Onyx (ev3, Irvine, USA) using a combination of endovascular adjuvant techniques: pressure cooker and remodeling balloon protection of cerebral artery. The article includes previously published observations of such fistulas and discusses anatomic features and venous drainage of dural arteriovenous fistulas in the given location.

Flow-sensitive alternating inversion recovery (fair) imaging for retrograde cortical venous drainage related to intracranial dural arteriovenous fistula

2010 ◽  
Vol 53 (3) ◽  
pp. 153-158 ◽  
Author(s):  
Kyo Noguchi ◽  
Naoya Kuwayama ◽  
Michiya Kubo ◽  
Yuichi Kamisaki ◽  
Keisuke Kameda ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Inversion Recovery ◽  
Cortical Venous Drainage

scholarly journals Utility of targeted balloon protection of the venous sinus for endovascular treatment of dural arteriovenous fistula by transarterial embolization with Onyx: A case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 340
Author(s):  
Masahiko Tagawa ◽  
Akihiro Inoue ◽  
Kentaro Murayama ◽  
Shirabe Matsumoto ◽  
Saya Ozaki ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Successful Treatment ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Venous Drainage ◽  
Venous Sinus ◽  
Occipital Artery ◽  
Balloon Protection ◽  
Sinus Flow

Background: Onyx has already been reported as an effective and safe agent in transarterial embolization of cranial dural arteriovenous fistula (d-AVF). However, successful treatment is related to not only complete shunt obliteration but also preservation of a normal route of venous drainage. Here, we present a case of transverse sigmoid d-AVF in which successful treatment was achieved by transarterial Onyx embolization with targeted balloon protection of the venous drainage. Case Description: A 70-year-old man presented with a 3-month history of tinnitus in the left ear and mild headache. Magnetic resonance imaging (MRI) showed a cluster of abnormal blood vessels in the area of the left transverse sinus (TS)-sigmoid sinus (SS) junction. Cerebral angiography demonstrated a Cognard type IIa d-AVF at the left TS-SS junction, supplied mainly by vessels such as the left middle meningeal artery, left occipital artery, and left meningohypophyseal trunk. In the venous phase, the ipsilateral TS-SS was recognized as a functional sinus and the left vein of Labbe drained into the TS near the drainage channel. Based on these findings, we decided to perform endovascular treatment under a transarterial approach with Onyx using targeted balloon protection of the venous sinus to protect against Onyx migration and preserve antegrade sinus flow. The patient recovered well without sequelae, and follow-up MRI 12 months later showed complete disappearance of the d-AVF. Conclusion: This treatment strategy using targeted balloon protection may be very useful to preserve antegrade sinus flow in patients with Cognard type IIa d-AVF.

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