Surgical Transvenous Embolization of a Carotid-Cavernous Dural Fistula with Cortical Drainage via a Petrosal Vein: Two Technical Case Reports

Neurosurgery ◽  
2002 ◽  
Vol 50 (6) ◽  
pp. 1380-1384 ◽  
Author(s):  
Tsuyoshi Hara ◽  
Jun-ichiro Hamada ◽  
Yutaka Kai ◽  
Yukitaka Ushio
Keyword(s):  
Case Reports ◽  
Transvenous Embolization ◽  
Guglielmi Detachable Coils ◽  
Dural Fistula ◽  
Petrosal Vein ◽  
Ocular Symptoms ◽  
Detachable Coils ◽  
Endovascular Approach ◽  
Transvenous Approach ◽  
Fistula Site

Abstract OBJECTIVE AND IMPORTANCE We present two interesting cases involving carotid-cavernous dural fistulae draining only or predominantly into the petrosal vein after previous incomplete, complicated, endovascular treatments. Transvenous embolization with Guglielmi detachable coils, via the petrosal vein, during surgical exposure completely obliterated the fistulae. CLINICAL PRESENTATION A 64-year-old man manifesting left ocular symptoms after incomplete embolization of a left carotid-cavernous dural fistula and a 56-year-old woman manifesting left hemiparesis after complicated embolization of a right carotid-cavernous dural fistula were referred to our hospital. A percutaneous transvenous approach was attempted in both cases, but the catheter could not reach the fistula site. A combined open surgical and endovascular approach was then used. INTERVENTION The hemispheric branch of the petrosal vein was exposed via a retromastoid craniectomy. The catheter was then directly introduced into the hemispheric branch, followed by navigation into the fistula site. The fistula was completely embolized with Guglielmi detachable coils. CONCLUSION The technique of surgical transvenous embolization via a petrosal vein is a valuable alternative for the treatment of carotid-cavernous dural fistulae that drain only or predominantly into the petrosal vein, when the percutaneous transvenous route is not accessible.

scholarly journals Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula

2015 ◽  
Vol 10 (1) ◽  
pp. 55 ◽  
Author(s):  
Marco Zenteno ◽  
Santos-Franco Jorge ◽  
Moscote-SalazarLuis Rafael ◽  
AlvisMirandaHernando Raphael ◽  
Alcala-Cerra Gabriel ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Guglielmi Detachable Coils ◽  
Dural Fistula ◽  
Detachable Coils ◽  
Transvenous Approach

scholarly journals Endovascular treatment evolution for pure intraorbital arteriovenous fistula: Three case reports and literature review

2017 ◽  
Vol 30 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Xianli Lv ◽  
Wei Li ◽  
Aihua Liu ◽  
Ming Lv ◽  
Chuhan Jiang
Keyword(s):  
Arteriovenous Fistula ◽  
Case Reports ◽  
Treatment Options ◽  
Transvenous Embolization ◽  
Arteriovenous Fistulas ◽  
The Past ◽  
Nerve Sheath ◽  
Recent Developments ◽  
Blurry Vision ◽  
Transvenous Approach

Background and importance Intraorbital arteriovenous fistulas (IOAVFs) are rare and cause eye redness, exophthalmos, blurry vision and bruit. Whereas in the past they were treated conservatively, surgically or transarterially, recent developments in transvenous embolization have improved their treatment. In this paper the authors report three cases of IOAVFs treated endovascularly and review the evolution of treatment options. Methods Three cases of purely IOAVF enrolled in our center were reported and a PubMed literature search was performed using “pure intraorbital arteriovenous fistula” and “arteriovenous fistula of the optic nerve sheath.” A total of 21 papers were reviewed in full, focusing primarily on the treatment and outcomes. Results A total of 26 patients were obtained, including our three patients and 23 patients reported in the literature. In nine patients treated conservatively, four spontaneous occlusions, one visual deterioration and four cases with unknown outcome were reported. In another 18 patients, 29 therapies (including five surgical treatment, 11 transarterial embolizations and 13 transvenous embolizations) were attempted and resulted in 12 cures, five visual deteriorations and one without reported outcome. More recently, transvenous embolization has become the mainstay of IOAVF treatment. Of the 21 patients assessed between 2000 and 2013, a transvenous approach was attempted in 13 patients; nine patients were cured without any adverse events. Conclusion Development and improvement of transvenous techniques are found to be safe and effective for patients with IOAVF.

scholarly journals “Mirror” Aneurysms Involving the Bilateral Distal Posterior Cerebral Artery

2004 ◽  
Vol 10 (3) ◽  
pp. 231-234 ◽  
Author(s):  
S.K. Baik ◽  
C.H. Sohn ◽  
S.K. Woo
Keyword(s):  
Subarachnoid Haemorrhage ◽  
Cerebral Artery ◽  
Posterior Cerebral Artery ◽  
Clinical Manifestations ◽  
Mirror Image ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils ◽  
Endovascular Approach

We report the case of patient with bilateral and symmetrical aneurysms, mirror image, of the distal posterior cerebral artery (PCA) who presented with subarachnoid haemorrhage. The aneurysms were treated by endovascular approach using Guglielmi detachable coils (GDCs). A review of the pathophysiology, clinical manifestations and management of mirror aneurysms is presented and discussed.

Endovascular coil embolization of residual or recurrent aneurysms after surgical clipping

2000 ◽  
Vol 41 (2) ◽  
pp. 111-115 ◽  
Author(s):  
H.S. Cekirge ◽  
C. Islak ◽  
M.M. Firat ◽  
N. Kocer ◽  
I. Saatci
Keyword(s):  
Treatment Option ◽  
Coil Embolization ◽  
Guglielmi Detachable Coils ◽  
Surgical Clipping ◽  
Present Treatment ◽  
Complete Obliteration ◽  
Detachable Coils ◽  
Endovascular Coil Embolization ◽  
Endovascular Approach ◽  
Good Treatment Option

Purpose: Treatment of residual or recurrent aneurysms after surgical clipping is a challenge and most surgeons prefer to avoid a second surgical attempt. We present treatment of 4 residual or recurrent aneurysms after surgical clipping with electrolytically detachable coils. Material and Methods: In 3 of 4 patients, recurrent aneurysms were diagnosed with angiography 2 months, 5 years and 14 years after surgery, although the domes of the aneurysms were opened following clipping during the surgery. In the 4th patient, an early postoperative angiogram revealed filling of a residual aneurysm secondary to the incomplete neck clipping. Guglielmi detachable coils were used to occlude the residual or recurrent aneurysm. Results: The endovascular approach was successful in all patients and the control angiograms showed complete obliteration of the aneurysms with no recanalization. Conclusion: The endovascular approach is a good treatment option for patients in whom complete obliteration of the aneurysm cannot be achieved by surgical clipping. Opening of the aneurysm sac after clipping does not necessarily preclude aneurysm regrowth from a neck remnant proximal to the clip.

scholarly journals Severe Subarachnoid Hemorrhage With Pulmonary Edema Successfully Treated by Intra-aneurysmal Embolization Using Guglielmi Detachable Coils. Two Case Reports.

2001 ◽  
Vol 41 (3) ◽  
pp. 135-139 ◽  
Author(s):  
Miki FUJIMURA ◽  
Michiharu NISHIJIMA ◽  
Kunihiko UMEZAWA ◽  
Hiroyuki KON ◽  
Teruhiko TANAKA ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Pulmonary Edema ◽  
Case Reports ◽  
Guglielmi Detachable Coils ◽  
Detachable Coils

scholarly journals About an Intracranial Aneurysm Rupture During Delivery

2020 ◽  
Vol 09 (01) ◽  
pp. 52-54
Author(s):  
Ibrahim Assoumane ◽  
Loucif Houari ◽  
Abdelhalim Morsli
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Aneurysm ◽  
Aneurysm Rupture ◽  
Guglielmi Detachable Coils ◽  
Healthy Baby ◽  
Detachable Coils ◽  
Endovascular Approach ◽  
Cesarian Section

AbstractThe rupture of an intracranial aneurysm is rare during pregnancy and exceptional during delivery. When it occurs, the prognosis of two lives is engaged. We are reporting a case of a 41-year-old patient presenting with a subarachnoid hemorrhage during labor. After extraction of healthy baby through cesarian section, radiological investigations permitted to diagnose a ruptured right carotid-ophthalmic aneurysm. The patient benefited from a selective aneurysm’s exclusion by occlusion using Guglielmi detachable coils through an endovascular approach using catheterization. The immediate outcome was favorable.

scholarly journals Ocular adverse events associated with immune checkpoint inhibitors: a novel multidisciplinary management algorithm

2021 ◽  
Vol 13 ◽  
pp. 175883592199298
Author(s):  
Orthi Shahzad ◽  
Nicola Thompson ◽  
Gerry Clare ◽  
Sarah Welsh ◽  
Erika Damato ◽  
...  
Keyword(s):  
Adverse Events ◽  
Checkpoint Inhibitors ◽  
Case Reports ◽  
Case Series ◽  
Simple Algorithm ◽  
Cancer Therapeutics ◽  
Management Algorithm ◽  
Ocular Symptoms ◽  
Systemic Corticosteroids ◽  
Permanent Loss

Ocular immune-related adverse events (IrAEs) associated with use of checkpoint inhibitors (CPIs) in cancer therapeutics are relatively rare, occurring in approximately 1% of treated patients. Recognition and early intervention are essential because the degree of tissue damage may be disproportionate to the symptoms, and lack of appropriate treatment risks permanent loss of vision. International guidelines on managing ocular IrAEs provide limited advice only. Importantly, local interventions can be effective and may avoid the need for systemic corticosteroids, thereby permitting the continuation of CPIs. We present a single institution case series of eight affected patients managed by our multidisciplinary team. Consistent with previously published series and case reports, we identified anterior uveitis as the most common ocular IrAE associated with CPIs requiring intervention. Based on our experience, as well as published guidance, we generated a simple algorithm to assist clinicians efficiently manage patients developing ocular symptoms during treatment with CPIs. In addition, we make recommendations for optimising treatment of uveitis and address implications for ongoing CPI therapy.

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