Transvenous Embolization of Dural Arteriovenous Fistulas of the Hypoglossal Canal: Report of Three Cases and Review of the Literature

In this article, we report three cases of dural arteriovenous fistulas of the hypoglossal canal treated via transvenous approach. We also perform a review of the literature on the endovascular management of this type of lesions with particular attention to the dangerous extracranial-intracranial anastomoses that can occur at this level.

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Transvenous Embolization of Ethmoidal Dural Arteriovenous Fistulas: Case Series and Review of the Literature

World Neurosurgery ◽

10.1016/j.wneu.2017.11.095 ◽

2018 ◽

Vol 110 ◽

pp. e786-e793 ◽

Cited By ~ 5

Author(s):

Nicola Limbucci ◽

Giuseppe Leone ◽

Sergio Nappini ◽

Andrea Rosi ◽

Leonardo Renieri ◽

...

Keyword(s):

Case Series ◽

Transvenous Embolization ◽

Review Of The Literature ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

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Selective Transvenous Embolization of Dural Arteriovenous Fistulas Involving the Hypoglossal Canal

Interventional Neuroradiology ◽

10.1177/159101990701300108 ◽

2007 ◽

Vol 13 (1) ◽

pp. 59-66 ◽

Cited By ~ 22

Author(s):

M. Okahara ◽

H. Kiyosue ◽

S. Tanoue ◽

Y. Sagara ◽

Y. Hori ◽

...

Keyword(s):

Jugular Vein ◽

Critical Evaluation ◽

Venous Drainage ◽

Transvenous Embolization ◽

Venous Plexus ◽

Venous Anatomy ◽

Hypoglossal Canal ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Posterior Condylar

The hypoglossal canal contains a venous plexus that connects the inferior petrous sinus, condylar vein, jugular vein and paravertebral plexus. The venous plexus is one of the venous drainage routes of the posterior skull base. Only a few cases of dural arteriovenous fistulas (AVFs) involving the hypoglossal canal have been reported. We describe three cases (a 62-year-old female, a 52-year-old male, and an 83-year-old male) of dural AVFs involving the hypoglossal canal. Symptoms were pulse-synchronous bruit in two cases and proptosis/chemosis in one. All dural AVFs were mainly fed by the ipsilateral ascending pharyngeal artery. Two of three dural AVFs involving the hypoglossal canal mainly drained through the anterior condylar confluence into the inferior petrosal sinus retrogradely with antegrade drainage through the lateral condylar vein. The other one drained through the lateral and posterior condylar veins into the suboccipital cavernous sinus. All dural AVFs were completely occluded by selective transvenous embolization without any complications, and the symptoms disappeared within one week in all cases. Dural AVFs involving the hypoglossal canal can be successfully treated by selective transvenous embolization with critical evaluation of venous anatomy in each case.

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The Angle of the Microguidwire on the Lateral Projection: a Prediction of Cannulation of the Occluded Inferior Petrosal Sinuses for the Transvenous Embolization of Cavernous Sinus Dural Arteriovenous Fistulas

10.21203/rs.3.rs-707075/v1 ◽

2021 ◽

Author(s):

Xianli Lv

Keyword(s):

Internal Jugular Vein ◽

Cavernous Sinus ◽

Jugular Vein ◽

Inferior Petrosal Sinus ◽

Transvenous Embolization ◽

Lateral Projection ◽

Arteriovenous Fistulas ◽

Fluoroscopic Image ◽

Dural Arteriovenous Fistulas ◽

Transvenous Approach

Abstract OBJECTIVE: To describe that the angle of the guidwire on lateral projection under fluoroscopic image is a prediction of cannulation of the occluded inferior petrosal sinus in the transvenous embolization of cavernous sinus dural fistulas.METHODS: From January 2018 through January 2021, 12 consecutive cavernous sinus dural fistulas with ipsilateral inferior petrosal sinus occlusion identified in 12 patients were cured by cannulation of the occluded ipsilateral inferior petrosal sinus. Clinical, radiologic and procedure data of the 12 patients were retrospectively reviewed. The angle of microguidewire between on lateral projection under fluoroscopic image between the inferior petrosal sinus and the internal jugular vein was measured by 180°Protractor(Deli Group Co., LTD, Zhejiang, China). RESULTS: In the 12 patients, access via the occluded ipsilateral inferior petrosal sinus was primarily attempted as the transvenous approach. During the procedure, the angle of microguidwire on lateral projection under fluoroscopic image between the inferior petrosal sinus and the internal jugular vein was 117°±7°, which is very useful to confirm the cannulation of the occluded inferior petrosal sinus. Complete occlusion was achieved in all fistulas, with no procedure-related morbidity or mortality. Postprocedural symptom was improved in all patients. CONCLUSION: Cannulation of an occluded inferior petrosal sinus is possible and reasonable as an initial access attempt for cavernous sinus dural fistulas. The angle of microguidwire on the lateral projection under fluoroscopic image can help to confirm the orifice of the occluded inferior petrosal sinus.

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Endovascular management of complex superior sagittal sinus dural arteriovenous fistula

Neurosurgical FOCUS ◽

10.3171/2019.2.focusvid.18687 ◽

2019 ◽

Vol 46 (Suppl_2) ◽

pp. V11

Author(s):

André Beer-Furlan ◽

Krishna C. Joshi ◽

Hormuzdiyar H. Dasenbrock ◽

Michael Chen

Keyword(s):

Dural Arteriovenous Fistula ◽

Superior Sagittal Sinus ◽

Venous Drainage ◽

Endovascular Management ◽

Arteriovenous Fistulas ◽

Sagittal Sinus ◽

Dural Arteriovenous Fistulas ◽

Complete Obliteration ◽

Cortical Venous Drainage ◽

Transvenous Approach

Superior sagittal sinus (SSS) dural arteriovenous fistulas (DAVFs) are rare and present unique challenges to treatment. Complex, often bilateral, arterial supply and involvement of large volumes of eloquent cortical venous drainage may necessitate multimodality therapy such as endovascular, microsurgical, and stereotactic radiosurgery techniques. The authors present a complex SSS DAVF associated with an occluded/severely stenotic SSS. The patient underwent a successful endovascular transvenous approach with complete obliteration of the SSS. The authors discuss the management challenges faced on this case.The video can be found here: https://youtu.be/-rztg0_cBXY.

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Endovascular management of intracranial dural arteriovenous fistulas: A review

Clinical Neurology and Neurosurgery ◽

10.1016/j.clineuro.2012.11.021 ◽

2013 ◽

Vol 115 (3) ◽

pp. 241-251 ◽

Cited By ~ 21

Author(s):

Alejandro Santillan ◽

Michael Nanaszko ◽

Jan-Karl Burkhardt ◽

Athos Patsalides ◽

Y. Pierre Gobin ◽

...

Keyword(s):

Endovascular Management ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

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Endovascular management of intracranial dural arteriovenous fistulas

Handbook of Clinical Neurology - Arteriovenous and Cavernous Malformations ◽

10.1016/b978-0-444-63640-9.00011-4 ◽

2017 ◽

pp. 117-123 ◽

Cited By ~ 2

Author(s):

Celene B. Mulholland ◽

M. Yashar S. Kalani ◽

Felipe C. Albuquerque

Keyword(s):

Endovascular Management ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

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Transvenous embolization of cerebral dural arteriovenous fistulas

Cerebral Dural Arteriovenous Fistulas ◽

10.1016/b978-0-12-819525-3.00006-x ◽

2021 ◽

pp. 63-85

Author(s):

Jawad M. Khalifeh ◽

Robert T. Wicks ◽

Jennifer E. Kim ◽

Justin M. Caplan ◽

Cameron G. McDougall

Keyword(s):

Transvenous Embolization ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

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Transvenous embolization of a posterior condylar canal fistula causing pulsatile tinnitus

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-016280 ◽

2020 ◽

pp. neurintsurg-2020-016280

Author(s):

Waleed Brinjikji ◽

Giuseppe Lanzino ◽

Harry J Cloft

Keyword(s):

Skull Base ◽

Motor Vehicle ◽

Motor Vehicle Accident ◽

Treatment Decision ◽

Occipital Artery ◽

Pulsatile Tinnitus ◽

Transvenous Embolization ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Posterior Condylar

Dural arteriovenous fistulas of the skull base commonly present with pulsatile tinnitus. In our experience, transvenous embolization of dural arteriovenous fistulas of the skull base represents a safe and effective treatment modality due to its precision in treatment of the site of convergence of all feeding arteries and the low risk of ischemic complications. We present a case of an adult patient who presented to our institution with pulsatile tinnitus several months following a motor vehicle accident. Cerebral angiography demonstrated a dural arteriovenous fistula at the junction of the posterior condylar vein and suboccipital venous plexus supplied by branches of the vertebral artery, occipital artery, and ascending pharyngeal artery. In this operative video we demonstrate this technique and provide an in-depth discussion of our treatment decision-making process and the anatomical considerations involved in treating this lesion.

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