Endovascular treatment of isolated transverse sigmoid sinus dural arteriovenous fistula using Onyx liquid embolic system

2013 ◽  
Author(s):  
M. Kawanishi ◽  
N. Kawai ◽  
T. Tamiya ◽  
Shuxiang Guo
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Sigmoid Sinus ◽  
Liquid Embolic

scholarly journals Retrieval of a migrated N-butyl-2 cyanoacrylate cast using a snare-kit system during dural AVF embolization: A case report

2018 ◽  
Vol 24 (5) ◽  
pp. 571-573
Author(s):  
Ramy Ahmed ◽  
Satomi Ide ◽  
Hiro Kiyosue ◽  
Shuichi Tanoue ◽  
Shunro Matsumoto ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Endovascular Procedures ◽  
Sigmoid Sinus ◽  
Embolic Material ◽  
Coagulation Profile ◽  
Liquid Embolic

N-butyl-2 cyanoacrylate (NBCA) is a liquid embolic material that is widely used in various endovascular procedures because of its permanent and rapid vascular occluding effect regardless of the coagulation profile of the patient. However, NBCA migration to unintended vessels may result in serious complications. This report describes the retrieval of a migrated NBCA cast from the transverse-sigmoid sinus during dural arteriovenous fistula embolization using a transvenous snaring 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 Pediatric Traumatic Dural Arteriovenous Fistula

2009 ◽  
Vol 36 (6) ◽  
pp. 751-756 ◽  
Author(s):  
Michael Vassilyadi ◽  
Naveen Mehrotra ◽  
Mohammed F. Shamji ◽  
Jean Michaud
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Skull Fracture ◽  
Traumatic Injury ◽  
Middle Meningeal Artery ◽  
Neurological Status ◽  
Arterial Injury ◽  
Sigmoid Sinus ◽  
Dural Defect

Background:Dural arteriovenous fistulas are uncommon lesions in children, with traumatic lesions suspected to arise from incomplete arterial injury in proximity to a vein or draining sinus. Management of symptomatic acquired lesions requires evaluation of patient presentation, neurological status, and pathoanatomic configuration, with special consideration required for surgery secondary to failed endovascular technique.Case Report:A 12-year-old male sustained a bicycle fall causing a right temporo-parietal skull fracture associated with non-surgical right epidural hematoma and left contre-coup parietal contusion. Six-weeks later, he complained of a right temporal bruit with subsequent cerebral angiography demonstrating a dural-based fistula between the right middle meningeal artery and a dural vein draining into the sigmoid sinus.Intervention:Endovascular treatment of this lesion with glue embolization and coiling was unsuccessful, with angiographic illustration of previously unobserved collateral vessels and coils occupying the sigmoid sinus. A right temporo-parietal craniectomy was required to excise the dural-based fistula, followed by dural defect repair with bovine pericardium and subsequent cranioplasty. Six years later the patient remains neurologically intact with no headaches or bruit.Conclusions:Dural arteriovenous fistula can uncommonly occur following traumatic injury in children. Partial injury to the middle mengineal artery may have established arterial communication with the draining vein that became ectatic and tortuous under high pressure. Failure of primary endovascular treatment may complicate secondary surgical intervention.

Transvenous Coil Embolization of a Transverse-Sigmoid Sinus Dural Arteriovenous Fistula: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Santiago Gomez-Paz ◽  
Yosuke Akamatsu ◽  
Mohamed M Salem ◽  
Justin M Moore ◽  
Ajith J Thomas ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Fistula ◽  
Coil Embolization ◽  
Dural Arteriovenous Fistula ◽  
External Carotid Artery ◽  
Sigmoid Sinus ◽  
Definitive Treatment ◽  
External Carotid ◽  
Type I ◽  
Patient Consent

Abstract This case is a 66-yr-old woman with a 2-mo history of left-sided tinnitus. Workup with magnetic resonance angiography showed early opacification of the left sigmoid sinus and internal jugular vein as well as asymmetric and abundant opacification of the left external carotid artery branches, suspicious for a dural arteriovenous fistula (dAVF). Diagnosis was confirmed with cerebral angiography, consistent with a left-sided Cognard type I dAVF.1 Initial treatment attempt was made with transarterial 6% ethylene-vinyl alcohol copolymer (Onyx 18) embolization of feeders from the occipital and middle meningeal arteries. However, embolization was not curative and there was a recurrence of a highly bothersome tinnitus 3 wk following treatment. Angiography redemonstrated the transverse sinus dAVF with new recruitment arising from several feeders, including the left external carotid artery, middle meningeal artery, and superficial temporal artery, now Cognard type IIa. Definitive treatment through a transvenous coil embolization provided permanent obliteration of the fistula without recrudescence of symptoms on follow-up. In this video, the authors discuss the nuances of treating a dAVF via a transvenous embolization. Patient consent was given prior to the procedure, and consent and approval for this operative video were waived because of the retrospective nature of this manuscript and the anonymized video material.

scholarly journals Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Shuhei Kawabata ◽  
Hajime Nakamura ◽  
Takeo Nishida ◽  
Masatoshi Takagaki ◽  
Nobuyuki Izutsu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Anterior Cranial Fossa ◽  
Maxillary Artery ◽  
Flow Reduction ◽  
Cranial Fossa ◽  
Embolic Materials

ABSTRACT Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, high blood flow from the internal maxillary artery (IMA) often impedes penetration of embolic materials into the shunt pouch. Therefore, reducing blood flow from the IMA before embolization can increase the success rate. In the present case, to reduce blood flow from branches of the IMA, we inserted surgical gauze infiltrated with xylocaine and epinephrine into bilateral nasal cavities. Using this method, we achieved curative TAE with minimal damage to the nasal mucosa. Transnasal flow reduction is an easy, effective and minimally invasive method. This method should be considered in the endovascular treatment of ACF–dAVF, especially in patients with high blood flow from theIMA.

Gradual dilatation of an occluded transverse sinus associated with dural arteriovenous fistula after balloon angioplasty with sinus packing: A case report

2021 ◽  
pp. 197140092110415
Author(s):  
Takuya Osuki ◽  
Hiroyuki Ikeda ◽  
Tomoko Hayashi ◽  
Silsu Park ◽  
Minami Uezato ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Balloon Angioplasty ◽  
Dural Arteriovenous Fistula ◽  
Executive Dysfunction ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
Shunt Flow ◽  
Symptomatic Epilepsy ◽  
The Right

Background There is no consensus as to whether balloon angioplasty alone or stent placement is effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse sinus occlusion associated with DAVF in which gradual sinus dilatation was observed after balloon angioplasty with embolization of the affected sinus with shunt flow. Case presentation A 69-year-old man presented with executive dysfunction. Magnetic resonance imaging revealed left transverse sinus–sigmoid sinus DAVF with occlusion of the left jugular vein and right transverse sinus. Before endovascular treatment, the patient had symptomatic epilepsy and subarachnoid hemorrhage. Retrograde leptomeningeal venous drainage disappeared with packing of the left transverse sinus–sigmoid sinus. Subsequently, balloon angioplasty of the right occluded transverse sinus was performed to maintain the normal venous drainage and remaining shunt outflow. Dilatation of the right transverse sinus was poor immediately after surgery. However, angiography after 10 days and 6 months revealed gradual dilatation of the right transverse sinus. Conclusion Sinus occlusion, which is thought to be caused by sinus hypertension associated with DAVF rather than chronic organized thrombosis or thrombophilia, may dilate over time after balloon angioplasty and shunt flow reduction if occluded sinus is necessary for facilitating normal venous drainage.

Sign in / Sign up

Export Citation Format

Share Document