scholarly journals Transvenous Embolization of Dural Arteriovenous Fistula of the Cavernous Sinus

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 85-92 ◽  
Author(s):  
S. Takahashi ◽  
I. Sakuma ◽  
N. Tomura ◽  
J. Watarai ◽  
K. Mizoi
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Gadopentetate Dimeglumine ◽  
Venous Access ◽  
Transvenous Embolization ◽  
Mr Images ◽  
Transfemoral Approach ◽  
Posterior Portion ◽  
Contrast Enhanced

We reviewed magnetic resonance (MR) images and digital subtraction angiograms (DSA) from eight patients with dural arteriovenous fistula of the cavernous sinus (DAVFCS) to clarify the fistulous points and to evaluate the venous access routes into the cavernous sinus for transvenous embolization (TVE). Multiplanar reconstruction of the MR images was achieved using three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) after the intravenous administration of gadopentetate dimeglumine (Gd-DTPA). TVE was performed using microcoils via the inferior petrosal sinus (IPS) using the transfemoral approach in five patients, via the facial vein and superior ophthalmic vein (SOV) using the transfemoral approach in 1 patient, and by SOV puncture in two patients. Most fistulas were detected in the posterior portion of the cavernous sinus or in the posterior intercavernous sinus in all of the patients. Fistulas identified as hyperintense dots or lines on contrast-enhanced 3-D fast SPGR images and were replaced with the microcoils. Target embolization of the fistulas was feasible in three patients treated via the SOV and in one patient treated via the IPS. Contrast-enhanced 3-D fast SPGR can help to identify the fistulous points of DAVFCS. Precise identification of fistulous points and selection of the adequate access route are mandatory for efficient TVE of DAVFCS.

scholarly journals Transvenous Embolization for Dural Arteriovenous Shunt of the Cavernous Sinus

2007 ◽  
Vol 13 (4) ◽  
pp. 353-358 ◽  
Author(s):  
S. Kato ◽  
H. Ishihara ◽  
H. Nakayama ◽  
M. Fujii ◽  
H. Fujisawa ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Transarterial Embolization ◽  
Arteriovenous Shunt ◽  
Complete Disappearance ◽  
Transvenous Embolization ◽  
Arteriovenous Shunts

We describe the treatment and follow-up clinical symptoms and angiographic results in patients with dural arteriovenous fistula of the cavernous sinus treated by transvenous embolization (TVE). We have treated eight cases of dural arteriovenous fistula of the cavernous sinus by multi-staged TVE in two cases and TVE with sinus packing in six and three of six cases were treated with a combination of transarterial embolization. Multi-staged TVE was performed by occlusion from dangerous drainage veins to the cavernous sinus on several occasions. Angiographical results showed disappearance or reduction of the arteriovenous shunt in all cases. Six patients presented with ophthalmic symptoms and two had tinnitus. Six cases had complete disappearance of clinical symptoms after treatment. There was a deterioration of ocular movement in one patient treated by TVE with sinus packing. Multi-staged TVE was performed to reduce the coil volume for the packing of the cavernous sinus in two cases without cranial nerve palsy. Embolization, especially multi-staged TVE, was considered a good treatment to occlude arteriovenous shunts at the cavernous sinus without cranial nerve complications.

Resolution of Trigeminal Neuralgia After Transvenous Embolization of a Cavernous Sinus Dural Arteriovenous Fistula

2017 ◽  
Vol 98 ◽  
pp. 880.e5-880.e8 ◽  
Author(s):  
Kenji Fukutome ◽  
Ichiro Nakagawa ◽  
Hun Soo Park ◽  
Takeshi Wada ◽  
Yasushi Motoyama ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Transvenous Embolization

scholarly journals Cavernous sinus dural arteriovenous fistula accessed through a straightened superficial temporal vein

2021 ◽  
Vol 12 ◽  
pp. 634
Author(s):  
Teishiki Shibata ◽  
Yusuke Nishikawa ◽  
Takumi Kitamura ◽  
Mitsuhito Mase
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Chronic Total Occlusion ◽  
Nerve Palsy ◽  
Dural Arteriovenous Fistula ◽  
Abducens Nerve ◽  
Transvenous Embolization ◽  
Access Route ◽  
Treatment Procedure ◽  
Total Occlusion

Background: Transvenous embolization through the inferior petrosal sinus (IPS) is the most common treatment procedure for cavernous sinus dural arteriovenous fistula (CSDAVF). When the IPS is inaccessible or the CSDAVF cannot be treated with transvenous embolization through the IPS, the superficial temporal vein (STV) is used as an alternative access route. However, the approach through the STV is often challenging because of its tortuous and abruptly angulated course. We report a case of recurrent CSDAVF which was successfully treated using a chronic total occlusion (CTO)-dedicated guidewire and by straightening the STV. Case Description: A 63-year-old woman was diagnosed with CSDAVF on examination for oculomotor and abducens nerve palsy. She was initially treated with transvenous embolization through the IPS. However, CSDAVF recurred, and transvenous embolization was performed through the STV. A microcatheter could not be navigated because of the highly meandering access route through the STV. By inserting a CTO-dedicated guidewire into the microcatheter, the STV was straightened and the microcatheter could be navigated into a shunted pouch of the CS. Finally, complete occlusion of the CSDAVF was achieved. Conclusion: If an access route is highly meandering, the approach can be facilitated by straightening the access route with a CTO-dedicated guidewire.

scholarly journals Spontaneous closure of a cavernous sinus dural arteriovenous fistula with spinal perimedullary drainage (Cognard V) during attempted transvenous embolization

2019 ◽  
Vol 14 (4) ◽  
pp. 1268
Author(s):  
Prasert Iampreechakul ◽  
Korrapakc Wangtanaphat ◽  
Punjama Lertbutsayanukul ◽  
Yodkhwan Wattanasen ◽  
Somkiet Siriwimonmas
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Spontaneous Closure ◽  
Transvenous Embolization

scholarly journals Cavernous Sinus Dural Arteriovenous Fistula Unresponsive to Transvenous Embolization Via the Inferior Petrosal Sinus

2005 ◽  
Vol 33 (3) ◽  
pp. 180-186
Author(s):  
Masato OHKI ◽  
Takamasa KAYAMA ◽  
Yasuaki KOKUBO ◽  
Shinjiro SAITO ◽  
Rei KONDO ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Inferior Petrosal Sinus ◽  
Transvenous Embolization

A Case of Sigmoid Sinus Dural Arteriovenous Fistula after Treated Cavernous Dural Arteriovenous Fistula

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 219-222 ◽  
Author(s):  
T. Makiuchi ◽  
K. Takasaki ◽  
M. Yamagami ◽  
H. Oda ◽  
K. Todoroki ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Sigmoid Sinus ◽  
External Carotid ◽  
Transvenous Embolization ◽  
Superior Ophthalmic Vein ◽  
Transfemoral Approach ◽  
Sinus Wall

Transvenous embolization has been recommended recently as the primary treatment for symptomatic cavernous dural arteriovenous fistula(dural AVF). We present a case of sigmoid sinus dural AVF which developed after transvenous embolization of cavernous dural AVF A 43-year-old man was admitted to our hospital because of left conjunctival chemosis, exophthalmus and abducens nerve palsy. Cerebral angiograms showed left cavernous dural AVF fed by the bilateral internal and external carotid arteries and draining into the enlarged left superior ophthalmic vein. Transfemoral approach in the cavernous sinus via inferior petrosal sinus (IPS) was difficult because of the occlusive change of IPS. Then, direct canulation of the left superior ophthalmic vein and transvenous embolization using interlocking detachable coils (IDC) were performed. Dural AVF and clinical symptoms were disappeard rapidly after embolization. Six months later, follow-up cerebral angiograms showed development of a dural AVF in the left sigmoid sinus. The pathogenesis of dural AVF remains unclear. We suggest that injury to the sinus wall during endovascular procedures may have provoked the development of dural AVF in our case. Clinical and angiographical follow-up are important.

scholarly journals Evaluation for shunted pouches of cavernous sinus dural arteriovenous fistula and the treatment outcome of transvenous embolization

2017 ◽  
Vol 24 (2) ◽  
pp. 189-196 ◽  
Author(s):  
Masaki Sato ◽  
Takashi Izumi ◽  
Noriaki Matsubara ◽  
Masahiro Nishihori ◽  
Shigeru Miyachi ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Three Dimensional ◽  
Transvenous Embolization ◽  
Posterior Compartment ◽  
Selective Embolization ◽  
Complete Occlusion

Background This study aimed to evaluate the detailed location and the number (single or multiple) of cavernous sinus dural arteriovenous fistula (CSDAVF) shunted pouches as well as the relationship between the characteristics of shunted pouch(es) and the treatment outcome of transvenous embolization for CSDAVF. Methods A total of 23 consecutive patients with CSDAVFs who underwent angiogram and transvenous embolization were retrospectively analyzed. Shunted pouches were assessed using three-dimensional angiogram and multiplanar reformatted image obtained from the rotational angiogram data. Results Of the 23 patients with CSDAVFs, 40 shunted pouches were identified. Twelve CSDAVFs had a single shunted pouch, and 11 had multiple shunted pouches. The mean CSDAVF with multiple shunted pouches was 2.5. The shunted pouches were more often found in the posterior compartment of the CS, which was connected with the intercavernous sinus (23/40; 57.5%). In 12 CSDAVFs with a single shunted pouch, 10 were treated with selective embolization and complete occlusion was achieved during the follow-up. Two CSDAVFs with single shunted pouch were just observed without intervention, and DAVFs disappeared spontaneously during the follow-up period. In 11 CSDAVFs with multiple shunted pouches, eight were treated with selective embolization and three with sinus embolization. In six of eight (75%), complete occlusion was achieved following selective embolization, but two of eight (25%) recurred and required retreatment. Conclusions Rotational angiography data suggested that the shunted pouches of CSDAVFs were mostly located in the posterior compartment of the CS connected with the intercavernous sinus. Selective embolization for CSDAVFs with a single shunted pouch is the first-line treatment alternative to sinus packing, and selective embolization with multiple shunted pouches will be a considerable treatment option.

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