Induced-Wedge Technique to Improve Liquid Embolic Agent Penetration into Spinal Dural Arteriovenous Fistula

2016 ◽  
Vol 96 ◽  
pp. 309-315 ◽  
Author(s):  
Dae Chul Suh ◽  
Su Hee Cho ◽  
Ji Eun Park ◽  
Hairi Liu ◽  
Sung Chul Jung
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Embolic Agent ◽  
Spinal Dural Arteriovenous Fistula ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Wedge Technique

scholarly journals Endovascular Treatment of Intracranial Pial–Dural Arteriovenous Fistula: A Case Report

2020 ◽  
Vol 06 (02) ◽  
pp. e118-e124
Author(s):  
D. V. Shchehlov ◽  
S. V. Konotopchyk ◽  
O. E. Svyrydiuk ◽  
I. M. Bortnik ◽  
M.Y. Momonova ◽  
...  
Keyword(s):  
Case Report ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
High Flow ◽  
Embolic Agent ◽  
Venous Stasis ◽  
Dural Sinus ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

AbstractIntracranial pial arteriovenous fistula (PAVF) is a rare cerebrovascular pathology characterized by abnormal direct high-flow connection between the pial or cortical feeding artery and draining vein. Dural arteriovenous fistula (DAVF) is a pathological shunt between the meningeal arteries and dural sinuses or meningeal veins. In case of association between PAVF and DAVF, diagnosis and treatment are more challenging. The high-flow arteriovenous shunt and deep venous drainage make PAVF more preferable for endovascular treatment; however, their embolization during single-session procedures can lead to extensive thrombosis of the draining veins and unfavorable outcomes. We present a case report of endovascular embolization of an intracranial PAVF–DAVF in a 2.5-year-old child. At the time of admission, the patient had hydrocephalus, mental retardation, pyramidal insufficiency, and seizures. Occlusion of the fistula was performed during two stages of embolization to reduce the risk of severe venous stasis and venous thrombosis. Guglielmi detachable coils (GDCs) and a liquid embolic agent (Histoacryl with Lipiodol) were used for embolization. The patient recovered well after the procedure, with significant mental improvement. This suggests that the deployment of GDCs in the afferent artery near a fistula before embolization with a liquid embolic agent can minimize the risk of uncontrolled penetration of the embolization into the draining veins and dural sinus. A multisession procedure can be an effective and reasonable method of PAVF and DAVF occlusion among existing treatment options.

scholarly journals Transvenous Treatment of a Dural Arteriovenous Fistula of the Transverse Sinus by Embolization with Platinum Coils and Onyx HD 500+

2005 ◽  
Vol 11 (3) ◽  
pp. 281-286 ◽  
Author(s):  
R. Siekmann ◽  
W. Weber ◽  
B. Kis ◽  
D. Kühne
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Balloon Occlusion ◽  
Embolic Agent ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Transvenous Approach ◽  
Platinum Coils

We report the endovascular treatment of a symptomatic dural arteriovenous fistula in a 61-year-old male patient. The medial portion of the fistula was occluded with detachable platinum coils during an initial intervention using a transvenous approach. Due to persistence of the symptoms in a second intervention eight months later the fistula was completely occluded by the transvenous introduction of a liquid embolic agent (Onyx 500+). The liquid embolic agent was introduced under protection by the temporary balloon occlusion of the fistula's venous drainage. After the procedure, the patient was treated for three months with 75 mg clopidogrel (Plavix®) and with 100 mg acetylsalicylic acid (ASS®). A few days after the intervention, the patient was discharged without any neurological deficit and in good clinical condition. The follow-up examination six months later neither detected a recurrence of the dural arteriovenous fistula in the angiogram nor any neurological symptoms.

scholarly journals Transarterial Embolisation of Dural Arteriovenous Fistula Involving an Isolated Segment of the Superior Petrosal Sinus

2000 ◽  
Vol 6 (4) ◽  
pp. 337-341
Author(s):  
C.H. Alleyne ◽  
Z. Numaguchi ◽  
H.Z. Wang
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Cure ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Embolic Agent ◽  
Liquid Embolic ◽  
Isolated Segment ◽  
Superior Petrosal Sinus ◽  
Liquid Embolic Agent

This case report illustrates a relatively rare case of dural arteriovenous fistula (AVF) involving direct supply to an isolated segment of the superior petrosal sinus (SPS). Successful transarterial obliteration of the lesion was accomplished with only a liquid embolic agent with long-term angiographic and clinical cure.

scholarly journals Two Microcatheter Technique for Embolization of Arteriovenous Fistula with Liquid Embolic Agent

2014 ◽  
Vol 9 (1) ◽  
pp. 32 ◽  
Author(s):  
Lin-Bo Zhao ◽  
Jae Ho Shim ◽  
Dong-geun Lee ◽  
Dae Chul Suh
Keyword(s):  
Arteriovenous Fistula ◽  
Embolic Agent ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

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.

Spinal Dural Arteriovenous Fistula: Diagnosis and Treatment

2018 ◽  
Vol 1 (2) ◽  
Author(s):  
Nur Setiawan Suroto
Keyword(s):  
Spinal Cord ◽  
Arteriovenous Fistula ◽  
Vascular Malformation ◽  
Dural Arteriovenous Fistula ◽  
Motor Symptoms ◽  
Elderly Men ◽  
Spinal Dural Arteriovenous Fistula ◽  
Sensory Disturbances ◽  
Av Fistulas ◽  
Low Rate

Spinal dural arteriovenous (AV) fistulas are the most commonly encountered vascular malformation of the spinal cord and a treatable cause for progressive paraplegia or tetraplegia. They most commonly affected are elderly men and are classically found in the thoracolumbar region.Symptoms gradually progress or decline in a stepwise manner and are commonly associated with pain and sphincter disturbances. Surgical or endovascular disconnection of the fistula has a high success rate with a low rate of morbidity. Motor symptoms are most likely to improve after treatment, followed by sensory disturbances, and lastly sphincter disturbances.

Sign in / Sign up

Export Citation Format

Share Document