scholarly journals Transvenous Treatment of a Dural Arteriovenous Fistula of the Transverse Sinus by Embolization with Platinum Coils and Onyx HD 500+

2005 ◽  
Vol 11 (3) ◽  
pp. 281-286 ◽  
Author(s):  
R. Siekmann ◽  
W. Weber ◽  
B. Kis ◽  
D. Kühne
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Balloon Occlusion ◽  
Embolic Agent ◽  
Liquid Embolic ◽  
Liquid Embolic Agent ◽  
Transvenous Approach ◽  
Platinum Coils

We report the endovascular treatment of a symptomatic dural arteriovenous fistula in a 61-year-old male patient. The medial portion of the fistula was occluded with detachable platinum coils during an initial intervention using a transvenous approach. Due to persistence of the symptoms in a second intervention eight months later the fistula was completely occluded by the transvenous introduction of a liquid embolic agent (Onyx 500+). The liquid embolic agent was introduced under protection by the temporary balloon occlusion of the fistula's venous drainage. After the procedure, the patient was treated for three months with 75 mg clopidogrel (Plavix®) and with 100 mg acetylsalicylic acid (ASS®). A few days after the intervention, the patient was discharged without any neurological deficit and in good clinical condition. The follow-up examination six months later neither detected a recurrence of the dural arteriovenous fistula in the angiogram nor any neurological symptoms.

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 Transarterial Embolisation of Dural Arteriovenous Fistula Involving an Isolated Segment of the Superior Petrosal Sinus

2000 ◽  
Vol 6 (4) ◽  
pp. 337-341
Author(s):  
C.H. Alleyne ◽  
Z. Numaguchi ◽  
H.Z. Wang
Keyword(s):  
Arteriovenous Fistula ◽  
Clinical Cure ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Embolic Agent ◽  
Liquid Embolic ◽  
Isolated Segment ◽  
Superior Petrosal Sinus ◽  
Liquid Embolic Agent

This case report illustrates a relatively rare case of dural arteriovenous fistula (AVF) involving direct supply to an isolated segment of the superior petrosal sinus (SPS). Successful transarterial obliteration of the lesion was accomplished with only a liquid embolic agent with long-term angiographic and clinical cure.

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.

scholarly journals The Usefulness of Subcutaneous Infiltration of Epinephrine-Containing Lidocaine for Curative Transarterial Embolization of Dural Arteriovenous Fistula

2014 ◽  
Vol 20 (1) ◽  
pp. 91-95 ◽  
Author(s):  
Shigeru Yamauchi ◽  
Akimasa Nishio ◽  
Yoshinobu Takahashi ◽  
Yutaka Mitsuhashi ◽  
Yuzo Terakawa ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Balloon Occlusion ◽  
Manual Compression ◽  
Flow Reduction ◽  
Liquid Embolic ◽  
Key Points ◽  
A New Technique ◽  
Embolic Materials

Recently, transarterial embolization (TAE) with liquid embolic materials has been recognized as one of the curative therapeutic options for non-sinus type dural arteriovenous fistula (d-AVF). To prevent glue fragmentation and incomplete obliteration, flow reduction of transosseous high-flow feeders is one of the key points of this therapy. However, flow reduction of transosseous feeders is sometimes difficult with previously reported techniques such as particle embolization, manual compression, or proximal balloon occlusion. This report introduces a new technique to reduce the flow of transosseous feeders using epinephrine-containing lidocaine, and describes a case of intracranial d-AVF successfully treated with this technique. The usefulness and efficacy of the technique are discussed.

scholarly journals Transvenous Treatment of Cranial Dural Arteriovenous Fistulas with Hydrogel Coated Coils

2006 ◽  
Vol 12 (4) ◽  
pp. 319-326 ◽  
Author(s):  
P. Klurfan ◽  
T. Gunnarsson ◽  
I. Shelef ◽  
K.G. Terbrugge ◽  
R.A. Willinsky
Keyword(s):  
Venous Drainage ◽  
Venous Congestion ◽  
Embolic Agent ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Platinum Coil ◽  
Cortical Venous Reflux ◽  
Bare Platinum Coils ◽  
Transvenous Approach ◽  
Platinum Coils

Intracranial dural arteriovenous fistulas (DAVF) with cortical venous reflux may become symptomatic due to venous congestion or intracranial hemorrhage. Venous congestion in the orbit can also occur resulting in proptosis, chemosis, double vision and progressive visual loss. The transvenous approach has been used for selective disconnection of the venous drainage to eliminate the venous congestion and future risk of intracranial bleeding and/or neurological deficit. Hydrogel coated coils (HydroCoil®) expand after contact with blood causing the coils to swell up to five to 11 times a standard 10-system bare platinum coil. Due to this property, HydroCoils could have an advantage over platinum coils in the transvenous approach to embolization of DAVFs. Ten patients with symptomatic cranial DAVF underwent a transvenous embolization using HydroCoils as the only embolic agent or in a combination with bare platinum coils. The patients' characteristics, symptoms, angioarchitecture of the DAVF, treatment, complications and results were analyzed. All the treated DAVFs were disconnected at the end of the procedure. All the patients with orbital symptoms had complete or significant improvement. There were no periprocedural complications. Nine patients had radiological follow-up showing cure. HydroCoils can be used effectively and safely to treat intracranial DAVFs transvenously. The volume expansion of Hydrocoils may have significant advantage over bare platinum coils given the large venous spaces that need to be filled. The use of HydroCoils may decrease the procedure time and consequently reduce the radiation dose to the patient.

scholarly journals Two Microcatheter Technique for Embolization of Arteriovenous Fistula with Liquid Embolic Agent

2014 ◽  
Vol 9 (1) ◽  
pp. 32 ◽  
Author(s):  
Lin-Bo Zhao ◽  
Jae Ho Shim ◽  
Dong-geun Lee ◽  
Dae Chul Suh
Keyword(s):  
Arteriovenous Fistula ◽  
Embolic Agent ◽  
Liquid Embolic ◽  
Liquid Embolic Agent

Unique percutaneous direct puncture technique for occlusion of a hypoglossal canal dural arteriovenous fistula

2018 ◽  
Vol 10 (12) ◽  
pp. 1179-1182 ◽  
Author(s):  
Orlando M Diaz ◽  
Maria M Toledo ◽  
John O F Roehm ◽  
Richard P Klucznik ◽  
Ponraj Chinnadurai ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Embolic Agent ◽  
Direct Puncture ◽  
Ethylene Vinyl Alcohol ◽  
Siemens Healthcare ◽  
Hypoglossal Canal ◽  
Liquid Embolic Agent ◽  
Detachable Coils ◽  
Anterior Condylar Vein

PurposeTo report percutaneous transcranial puncture, embolization and occlusion of a very symptomatic hypoglossal canal/anterior condylar vein dural arteriovenous fistula (DAVF) using syngo iGuide navigational software in a patient in whom transarterial and transvenous embolization and surgery had failed.MethodsAfter unsuccessful arterial and venous embolization and surgical treatment of a symptomatic hypoglossal canal DAVF, a 47-year-old man was transferred for further management. With exquisite anatomic detail provided by C-arm cone-beam computed tomography (CBCT) equipment (Artis zee Biplane, Dyna CT VC21H, Siemens Healthcare GmbH, Germany) and syngo iGuide needle guidance navigational software (Siemens Healthcare GmbHy) for planning a safe direct approach, the hypoglossal/anterior condylar vein, the dominant outflow vein of the fistula, was needle punctured percutaneously at the hypoglossal foramen and occluded with ethylene vinyl alcohol copolymer liquid embolic agent (Onyx, Medtronic, Minneapolis, Minnesota, USA) after placing two anchoring platinum coils (Target detachable coils, Stryker Neurovascular, Fremont, California, USA).ResultsAfter a year of progressively severe left eye proptosis, chemosis and increased intraocular pressure, the symptoms quickly subsided after this embolization and the patient was symptom free at his 3-month and later checkups.ConclusionWith guidance and imaging provided by CBCT and syngo iGuide navigational software, an otherwise untreatable DAVF was successfully embolized and obliterated by an aggressive unique percutaneous trans-cranial needle puncture of the dominant outflow vein in the hypoglossal canal.

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