scholarly journals Facial Vein Catheterization for Transvenous Embolization of the Cavernous Sinus

2006 ◽  
Vol 12 (1) ◽  
pp. 25-30 ◽  
Author(s):  
M.N. Karygiannis ◽  
Z. Szatmary ◽  
P.A. Claudino ◽  
E. Houdart
Keyword(s):  
Venous Thrombosis ◽  
Cavernous Sinus ◽  
Jugular Vein ◽  
Transvenous Embolization ◽  
Arteriovenous Fistulas ◽  
Vein Access ◽  
Facial Vein ◽  
Cervical Approach ◽  
Guiding Catheter ◽  
Vein Catheterization

We describe three cases of transvenous embolization of arteriovenous fistulas of the cavernous sinus, achieved through the facial vein approach. The facial vein was catheterized from a jugular vein access. This cervical approach offered good stability to the guiding catheter that permitted us to negotiate difficult curves of the facial vein and to recanalize venous thrombosis in one case.

scholarly journals 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

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.

scholarly journals Selective Transvenous Embolization of Dural Arteriovenous Fistulas Involving the Hypoglossal Canal

2007 ◽  
Vol 13 (1) ◽  
pp. 59-66 ◽  
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.

scholarly journals Percutaneous Transvenous Embolization of Intracranial Dural Arteriovenous Fistulas with Detachable Coils and/or in Combination with Onyx

2008 ◽  
Vol 14 (4) ◽  
pp. 415-427 ◽  
Author(s):  
Xianli Lv ◽  
Chuhan Jiang ◽  
Youxiang Li ◽  
Xinjian Yang ◽  
Zhongxue Wu
Keyword(s):  
Cavernous Sinus ◽  
Clinical Results ◽  
Sigmoid Sinus ◽  
Anterior Cranial Fossa ◽  
Transvenous Embolization ◽  
Arteriovenous Fistulas ◽  
Detachable Coils ◽  
Cranial Fossa ◽  
Age Range

This study evaluated angiographic and clinical results in patients with a dural arteriovenous fistula (DAVF) who underwent percutaneous transvenous embolization. Retrospective chart analysis and radiographic studies were performed in 23 patients (aged 11–70 yrs) with a DAVF treated with percutaneous transvenous embolization in the past five years. Lesions were located in the anterior cranial fossa, cerebellar tentorium, transverse-sigmoid sinus and cavernous sinus. All procedures were analyzed with regard to presentation, delivery, angiographical and clinical outcome. Data for 23 patients (age range, 11–70 yrs, mean age 49.5 yrs) with DAVFs (cavernous sinus[CS], n=17; transverse-sigmoid sinus, n=3; anterior cranial fossa, n=2; cerebellar tentorium, n=1) were retrospectively reviewed. The DAVFs were treated with coils or a combination with Onyx via different transvenous approaches, in 28 procedures. Cerebral angiography was performed to confirm the treatment. The mean clinical follow-up period was 22.1 months. Transvenous treatment of intracranial DAVFs can be safe and effective if various transvenous approaches are attempted. Percutaneous transvenous embolization with detachable platinum coils or a combination with Onyx is effective in the treatment of DAVFs.

A Useful Side-hole on a Guiding Catheter for Transvenous Embolization of a Transverse-sigmoid Sinus Dural Arteriovenous Fistula

2008 ◽  
Vol 63 (suppl_1) ◽  
pp. ONSE91-ONSE92
Author(s):  
Wataro Tsuruta ◽  
Yuji Matsumaru ◽  
Kensuke Suzuki ◽  
Tomoji Takigawa ◽  
Akira Matsumura
Keyword(s):  
Superior Sagittal Sinus ◽  
Jugular Vein ◽  
Sigmoid Sinus ◽  
Transvenous Embolization ◽  
Temporal Area ◽  
Side Hole ◽  
Sagittal Sinus ◽  
The Right ◽  
Transvenous Approach ◽  
Guiding Catheter

Abstract Objective: To report the usefulness of a side-hole on a guiding catheter for transvenous embolization of transverse-sigmoid sinus (TSS) dural arteriovenous fistulae (DAVF) by a contralateral approach with a reversed Y-shaped confluence. Clinical Presentation: A 66-year-old woman presented after an epileptic seizure. Magnetic resonance imaging revealed venous infarctions of the left temporal area. Angiography showed a DAVF in the left TSS with retrograde drainage toward the superior sagittal sinus and remarkable cortical reflux. Intervention: A transvenous approach through the right jugular vein was attempted after failure of the approach through the angiographically invisible left jugular vein. Catheterization beyond the confluence failed because the shape of the confluence was a reversed Y. A 5-French catheter with a side-hole was then placed in the superior sagittal sinus from the right TSS, and the microcatheter was successfully navigated into the left TSS through the side-hole. Subsequently, the DAVF was completely occluded by transvenous embolization without any adverse events. Conclusion: A side-hole on a guiding catheter was found to be useful for the navigation of a microcatheter to override a reversed Y-shaped confluence in transvenous embolization of TSS DAVF. This technique could be applicable to difficult configurations for transvenous catheterization, although attention should be paid to disruption of the catheter.

Alternative route to a hypoglossal canal dural arteriovenous fistula in case of failed jugular vein approach

2020 ◽  
pp. 159101992096119
Author(s):  
Rasmus Holmboe Dahl ◽  
Alessandra Biondi ◽  
Fortunato Di Caterino ◽  
Giovanni Vitale ◽  
Lars Poulsgaard ◽  
...  
Keyword(s):  
Nerve Palsy ◽  
Hypoglossal Nerve ◽  
Jugular Vein ◽  
Complete Regression ◽  
Unsuccessful Attempt ◽  
Hypoglossal Nerve Palsy ◽  
Hypoglossal Canal ◽  
Arteriovenous Fistulas ◽  
Vein Access ◽  
Alternative Routes

Hypoglossal canal dural arteriovenous fistulas (HC-DAVF) involve the anterior condylar vein (ACV) and anterior condylar confluence (ACC). They often present with tinnitus, bruit, and hypoglossal nerve palsy. The most common treatment in HC-DAVFs is transvenous embolization using coils and the most direct transvenous route is the trans-internal jugular vein access. When this approach is not feasible, a treatment attempt is possible through alternative routes. We report 2 patients with DAVFs involving the anterior condylar confluence. The first patient presented with pulsatile tinnitus and hypoglossal nerve palsy, and was treated by a standard transjugular approach. The second patient presented with pulse-synchronous bruit. Following an unsuccessful attempt of the transjugular approach, the fistulous point was reached via the deep cervical vein and complete occlusion was achieved by coil deployment. Both patients had complete regression of symptoms. Endovascular therapy is the elective treatment for HC-DAVFs and the transjugular approach is the most commonly used. The deep cervical vein (DCV) can be an alternative transvenous route when the transjugular approach fails.

Selective transvenous embolization combined with balloon angioplasty of the occluded inferior petrosal sinus for the treatment of cavernous sinus dural arteriovenous fistulas

2021 ◽  
pp. 159101992110162
Author(s):  
Satomi Ide ◽  
Hiro Kiyosue ◽  
Ryuichi Shimada ◽  
Yuzo Hori ◽  
Mika Okahara ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Balloon Angioplasty ◽  
Dural Sinus ◽  
Inferior Petrosal Sinus ◽  
Transvenous Embolization ◽  
Venous Flow ◽  
Period Range ◽  
Arteriovenous Fistulas ◽  
Venous Circulation ◽  
Dural Arteriovenous Fistulas

Background and purpose Angioplasty of the dural sinus has rarely been performed for the treatment of cavernous sinus dural arteriovenous fistulas. We evaluated the efficacy of selective transvenous embolization (TVE) combined with balloon angioplasty of the occluded inferior petrosal sinus (IPS) for the treatment of cavernous sinus dural arteriovenous fistulas (CSDAVFs). Materials and methods A total of 8 consecutive patients with CSDAVFs with occlusion of the IPS treated by selective TVE with balloon angioplasty of the IPS from July 2018 to January 2019 were retrospectively reviewed. There were 6 females and 2 males with an average age of 77.6 years. All patients showed ocular symptoms. Angiography showed cortical venous reflux in 7 cases and localized shunted pouches at the medial portion of the cavernous sinus, intercavernous sinus, or laterocavernous sinus. Selective TVE was performed via the occluded IPS with bilateral femoral venous approaches, and the occluded IPS was reconstructed by angioplasty with a 2- to 3-mm diameter balloon during or after selective TVE. Results CSDAVFs disappeared immediately after treatment, and the occluded IPSs were successfully reconstructed with re-establishment of normal antegrade venous flow in all cases. No complications were observed, and symptoms resolved within 2 weeks after treatment. During the 7-month mean follow-up period (range 1-12 months), no cases showed recurrence of CSDAVFs. Conclusion Selective TVE combined with balloon angioplasty of the occluded IPS is safe and effective for the treatment of CSDAVFs and re-establishes normal venous circulation in selected cases with localized shunted pouches.

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