scholarly journals Clinical Course of Cranial Dural Arteriovenous Fistulas With Long-Term Persistent Cortical Venous Reflux

Stroke ◽  
2002 ◽  
Vol 33 (5) ◽  
pp. 1233-1236 ◽  
Author(s):  
J. Marc C. van Dijk ◽  
Karel G. terBrugge ◽  
Robert A. Willinsky ◽  
M. Christopher Wallace
Keyword(s):  
Clinical Course ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

Selective disconnection of cortical venous reflux as treatment for cranial dural arteriovenous fistulas

2004 ◽  
Vol 101 (1) ◽  
pp. 31-35 ◽  
Author(s):  
J. Marc C. van Dijk ◽  
Karel G. TerBrugge ◽  
Robert A. Willinsky ◽  
M. Christopher Wallace
Keyword(s):  
Dural Sinus ◽  
Venous Reflux ◽  
Content Type ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux ◽  
Sinus Drainage ◽  
Fine Print

Object. A single-institution series of 119 consecutive patients with a dural arteriovenous fistula (DAVF) and cortical venous reflux was reviewed to assess the overall clinical outcome of multidisciplinary management after long-term follow up. The selective disconnection of the cortical venous reflux compared with the obliteration of the entire DAVF was evaluated. Methods. Dural arteriovenous fistulas in patients in this series were diagnosed between 1984 and 2001, and treatment was instituted in 102 of them. The outcome of adequately treated patients was compared with that of a control group consisting of those with persistent cortical venous reflux and with data found in the literature. In cases of combined dural sinus drainage and cortical venous reflux, a novel treatment concept of selective disconnection of the cortical venous reflux that left the sinus drainage intact, and thus converted the aggressive DAVF into a benign lesion, was evaluated. Endovascular treatment, which was instituted initially in 78 patients, resulted in an obliteration or selective disconnection in 26 (25.5%) of 102 cases. In 70 cases (68.6%) the DAVFs were surgically obliterated or disconnected. In six cases (5.9%), patients were left with persistent cortical venous reflux. No lasting complications were noted in this series. Follow-up angiography confirmed a durable result in 94 (97.9%) of 96 adequately treated cases, at a mean follow up of 27.6 months (range 1.4–138.3 months). Selective disconnection was performed in 23 DAVFs with combined sinus drainage and cortical venous reflux. These patients' long-term outcomes were equal to those with obliterated DAVFs, and the complication rate was lower. Conclusions. Considering the ominous course of DAVFs with patent cortical venous reflux, multidisciplinary treatment of these lesions is highly effective and the complication rate is low. Selective disconnection provides a valid treatment option of DAVFs with combined dural sinus drainage and cortical venous reflux, as has been shown in cranial DAVFs with direct cortical venous reflux.

Surgical Disconnection of the Cortical Venous Reflux for High-Grade Intracranial Dural Arteriovenous Fistulas

2015 ◽  
Vol 83 (4) ◽  
pp. 652-656 ◽  
Author(s):  
Rafid Al-Mahfoudh ◽  
Ramez Kirollos ◽  
Paul Mitchell ◽  
Maggie Lee ◽  
Hans Nahser ◽  
...  
Keyword(s):  
High Grade ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

Stereotactic Radiosurgery for Dural Arteriovenous Fistulas without Cortical Venous Reflux

2017 ◽  
Vol 107 ◽  
pp. 371-375 ◽  
Author(s):  
Daniel A. Tonetti ◽  
Bradley A. Gross ◽  
Brian T. Jankowitz ◽  
Kyle M. Atcheson ◽  
Hideyuki Kano ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

scholarly journals Lateral Sinus Dural Arteriovenous Fistulas: Sinovenous Outflow Restriction Outweighs Cortical Venous Reflux as a Parameter Associated with Hemorrhage

Radiology ◽  
2017 ◽  
Vol 285 (2) ◽  
pp. 528-535 ◽  
Author(s):  
Yong-Sin Hu ◽  
Chung-Jung Lin ◽  
Hsiu-Mei Wu ◽  
Wan-Yuo Guo ◽  
Chao-Bao Luo ◽  
...  
Keyword(s):  
Lateral Sinus ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

169 Stereotactic Radiosurgery for Dural Arteriovenous Fistulas Without Cortical Venous Reflux

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 243-243
Author(s):  
Daniel Tonetti ◽  
Bradley A Gross ◽  
Brian T Jankowitz ◽  
Kyle M Atcheson ◽  
Hideyuki Kano ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Low Risk ◽  
Pulsatile Tinnitus ◽  
Patient Counseling ◽  
Venous Reflux ◽  
Obliteration Rate ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

Abstract INTRODUCTION The rationale for treatment of dural arteriovenous fistulas (dAVF) without cortical venous reflux is symptomatic resolution. Most studies of dural arteriovenous fistula treatment, including those for stereotactic radiosurgery, have focused on angiographic obliteration instead of clinical symptomatic outcome. METHODS The authors evaluated their institutional experience with stereotactic radiosurgery for cerebral dAVFs without cortical venous reflux from 1991 to 2016, evaluating angiographic and clinical outcomes and focusing on the course of pulsatile tinnitus and/or ocular symptoms after treatment. They subsequently pooled their results with those published in the literature. RESULTS >Pooled outcomes data from 120 patients with pulsatile tinnitus and 229 patients with ocular symptoms were analyzed. Over a mean follow-up of 2.6 years, 77% of patients presenting with pulsatile tinnitus experienced resolution and an additional 21% had improvement, with an angiographic obliteration rate of 70.9%. Among 229 patients with ocular symptoms from carotid-cavernous dAVFs, improvement or resolution of symptoms occurred in 95% of those with chemosis, 90% of those with ophthalmoplegia, and 96% of those with proptosis. The angiographic obliteration rate was 76.2%. There were eight permanent complications out of 349 total treated low-risk dAVF (2.3%). CONCLUSION Rates of clinically-significant symptomatic improvement or resolution of symptoms referable to “low risk” dAVFs are even higher than their angiographic obliteration rate, an important factor in patient counseling and when considering the optimal treatment approach for these dAVFs.

scholarly journals Compromise of Brain Tissue Caused by Cortical Venous Reflux of Intracranial Dural Arteriovenous Fistulas

Stroke ◽  
2011 ◽  
Vol 42 (4) ◽  
pp. 998-1003 ◽  
Author(s):  
Kenichi Sato ◽  
Hiroaki Shimizu ◽  
Miki Fujimura ◽  
Takashi Inoue ◽  
Yasushi Matsumoto ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

The Rebuilding of Normal Venous Circulation for Transverse-Sigmoid Dural Arteriovenous Fistulas by Percutaneous Transluminal Angioplasty

1999 ◽  
Vol 5 (1_suppl) ◽  
pp. 109-114
Author(s):  
K. Yoshino ◽  
T. Yasuhara ◽  
M. Nakagawa ◽  
Y. Terai ◽  
S. Fujimoto ◽  
...  
Keyword(s):  
Percutaneous Transluminal Angioplasty ◽  
Transverse Sinus ◽  
Transluminal Angioplasty ◽  
Sigmoid Sinus ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Venous Circulation ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux ◽  
Percutaneous Transluminal

The etiology of dural arteriovenous fistulas (DAVFs) remains controversial as is the issue of whether occlusion or stenosis of the transverse sinus and sigmoid sinus is a cause or a result of DAVFs. We report a case of DAVFs with transverse-sigmoid sinus occlusion and cortical venous reflux. In this case, the reconstruction of normal venous circulation by percutaneous transluminal angioplasty (PTA) for the occluded sinus was performed and cortical venous reflux diminished. PTA may be a useful treatment for DAVFs with occluded or stenotic sinus.

Ophthalmic vein compression for selected benign low-flow cavernous sinus dural arteriovenous fistulas

2013 ◽  
Vol 119 (1) ◽  
pp. 239-242 ◽  
Author(s):  
Juan Pablo Cruz ◽  
Rene van Dijk ◽  
Timo Krings ◽  
Ronit Agid
Keyword(s):  
Cavernous Sinus ◽  
Carotid Arteries ◽  
Low Flow ◽  
External Carotid ◽  
Manual Compression ◽  
Venous Reflux ◽  
Arteriovenous Fistulas ◽  
Arteriovenous Shunts ◽  
Dural Arteriovenous Fistulas ◽  
Cortical Venous Reflux

Dural arteriovenous fistulas (DAVFs) of the cavernous sinus are acquired arteriovenous shunts between the dural branches of the internal and external carotid arteries and the cavernous sinus. These fistulas may present with cortical venous reflux, but more commonly drain antegradely toward the superior ophthalmic vein (SOV). Transvenous embolization is the most common endovascular treatment, but in some cases transvenous access to the compartment of the shunt may not be possible. In cases with no corticovenous reflux, manual compression of the SOV is an excellent alternative treatment, which is well known but rarely reported in the literature. The authors describe a series of 3 cavernous DAVFs with anterior drainage treated successfully by intermittent manual compression of the SOV.

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