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.

Usefulness of MRA in the Treatment of Dural AVM

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 177-180
Author(s):  
S. Kurokawa ◽  
Y. Tanaka ◽  
F. Ikeya ◽  
C. Maruki ◽  
M. Ebato ◽  
...  
Keyword(s):  
Contrast Medium ◽  
Cavernous Sinus ◽  
Time Of Flight ◽  
Sigmoid Sinus ◽  
Transvenous Embolization ◽  
Embolization Therapy ◽  
Time Of Flight Method ◽  
Dural Avm

We report 5 cases of dural AVMs, in which MRA images were considered very useful for evaluating the effectiveness of treatments, such as transvenous embolization therapy. MRA by time of flight method (TOF) with contrast medium for dural AVMs involving the cavernous sinus (dural CCFs) is necessary to assess the caliber of superior ophthalmic veins (SOVs) prior to treatment as well as immediately after treatment and during follow-up. MRA for dural AVM at the transverse-sigmoid sinus is useful for verifying thrombosed sinus in the dural AVM prior to transvenous embolization therapy and necessary to determine the approach to the nidus of the dural AVM2.

Dural Arteriovenous Fistulas Supplied by Ethmoidal Arteries

Neurosurgery ◽  
1990 ◽  
Vol 26 (5) ◽  
pp. 816-823 ◽  
Author(s):  
Van V. Halbach ◽  
Randall T. Higashida ◽  
Grant B. Hieshima ◽  
Charles B. Wilson ◽  
Stanley L. Barnwell ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Surgical Excision ◽  
Anterior Cranial Fossa ◽  
Additional Patient ◽  
Arteriovenous Fistulas ◽  
Atypical Symptoms ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Fistula Site

Abstract Eight patients with dural arteriovenous fistulas (DAVFs) located on the floor of the anterior cranial fossa and supplied by enlarged ethmoidal branches of the ophthalmic artery are described. Five patients showed the classical symptom of intracerebral hemorrhage (all five had ipsilateral frontal lobe hematomas and one also had an associated a subdural hematoma). Two patients exhibited atypical symptoms of proptosis, chemosis, elevated intraocular pressure, and loss of vision secondary to an ethmoidal DAVF, which drained posteriorly to the cavernous sinus. The eighth patient exhibited proptosis and chemosis secondary to a cavernous sinus DAVF and was incidentally found to have an asymptomatic ethmoidal DAVF. One additional patient had two separate dural fistulas: one located on the cribriform plate and the second located in the posterior fossa. Seven of the eight patients were cured by surgical excision of the fistula site; in the remaining patient spontaneous obliteration followed a surgical procedure for a cavernous DAVF. DAVFs involving the floor of the anterior cranial fossa usually present with hemorrhage, but can present with ocular symptoms or be entirely asymptomatic and are effectively treated by surgical excision of the fistula site.

Management strategies for anterior cranial fossa (ethmoidal) dural arteriovenous fistulas with an emphasis on endovascular treatment

2009 ◽  
Vol 110 (1) ◽  
pp. 79-84 ◽  
Author(s):  
Ronit Agid ◽  
Karel TerBrugge ◽  
Georges Rodesch ◽  
Tommy Andersson ◽  
Michael Söderman
Keyword(s):  
Endovascular Treatment ◽  
Endovascular Procedures ◽  
Treated Patient ◽  
Management Strategies ◽  
Anterior Cranial Fossa ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Open Surgical Treatment

Object Dural arteriovenous fistulas (DAVFs) of the anterior cranial fossa are rare lesions that can cause intracranial hemorrhage. Authors of previous reports mostly have described open surgical treatment for this fistula type. The authors' purpose in the present study was to describe their experience with anterior cranial fossa DAVFs, including their endovascular treatment. Methods All patients with anterior cranial fossa DAVFs diagnosed and treated in 3 separate institutions during the last 23 years were retrospectively identified. Clinical charts, imaging studies, and procedural notes were evaluated. Results Twenty-four patients (22 males and 2 females), ranging in age from 3 to 77 years, harbored 24 DAVFs in the anterior cranial fossa. Eleven patients were primarily treated with surgical disconnection and 2 with radiosurgery. Eleven patients were treated endovascularly; 7 of these patients (63.6%) were cured. In 4 cases of failed embolization, final disconnection was achieved through surgery. In fact, surgery was effective in disconnecting the fistula in 100% of cases. All endovascular procedures consisted of transarterial injections of diluted glue (N-butyl cyanoacrylate [NBCA]), and there were no complications. Brain edema developed around the venous pouch and confusion was apparent after venous disconnection in 1 surgically treated patient. No patient suffered a hemorrhage during the follow-up period. Conclusions Disconnection of an anterior cranial fossa DAVF by using transarterial catheterization through the ophthalmic artery and subsequent injection of NBCA is possible with a reasonable success rate and low risk for complications. In patients with good vascular access this procedure could be the treatment of choice, to be followed by open surgery in cases of embolization failure.

scholarly journals Transfemoral Transvenous Embolization of Dural Arteriovenous Fistulas Involving the Isolated Transverse-Sigmoid Sinus

2007 ◽  
Vol 13 (1_suppl) ◽  
pp. 109-114 ◽  
Author(s):  
Y. Kiura ◽  
S. Ohba ◽  
M. Shibukawa ◽  
S. Sakamoto ◽  
T. Okazaki ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Sigmoid Sinus ◽  
Transvenous Embolization ◽  
Ipsilateral Side ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Detachable Coils ◽  
Diagnostic Catheter ◽  
Guiding Catheter

Dural arteriovenous fistulas involving the transverse-sigmoid sinus (T-S dAVFs) are sometimes isolated because this affected sinus is often thrombosed. It is difficult to perform to microcatheter cannulation to the isolated sinus through the thrombosed portion. We are now treating these T-S dAVFs by transfemoral transvenous embolization via the ipsilateral side even if the affected sinus is thrombosed and isolated or not. We use a triaxial system (6 Fr. guiding catheter / 4 Fr. diagnostic catheter / microcatheter) to emphasize the pushability and handling of the microcatheter. And we insert 4 Fr. Catheter into the affected sinus. So we can perform microcatheter cannulation into the isolated and affected sinus for treatment by coil embolization with various detachable coils.

Gamma Knife surgery for low-flow cavernous sinus dural arteriovenous fistulas

2010 ◽  
Vol 113 (Special_Supplement) ◽  
pp. 21-27 ◽  
Author(s):  
Hyun Ho Jung ◽  
Jong Hee Chang ◽  
Kum Whang ◽  
Jin Soo Pyen ◽  
Jin Woo Chang ◽  
...  
Keyword(s):  
Gamma Knife ◽  
Cavernous Sinus ◽  
Transarterial Embolization ◽  
Gamma Knife Surgery ◽  
Low Flow ◽  
Close Monitoring ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas

Object The purpose of this study was to assess the efficacy of Gamma Knife surgery (GKS) for treating cavernous sinus dural arteriovenous fistulas (CSDAVFs). Methods Of the 4123 GKSs performed between May 1992 and March 2009, 890 procedures were undertaken to treat vascular lesions. In 24 cases, the vascular lesion that was treated was a dural arteriovenous fistula, and in 6 of these cases, the lesion involved the cavernous sinus. One of these 6 cases was lost to follow-up, leaving the other 5 cases (4 women and 1 man) to comprise the subjects of this study. All 5 patients had more than 1 ocular symptom, such as ptosis, chemosis, proptosis, and extraocular movement palsy. In all patients, CSDAVF was confirmed by conventional angiography. Three patients were treated by GKS alone and 2 patients were treated by GKS combined with transarterial embolization. The median follow-up period after GKS in these 5 cases was 30 months (range 9–59 months). Results All patients experienced clinical improvement, and their improvement in ocular symptoms was noticed at a mean of 17.6 weeks after GKS (range 4–24 weeks). Two patients received embolization prior to GKS but did not display improvement in ocular symptoms. An average of 20 weeks (range 12–24 weeks) was needed for complete improvement in clinical symptoms. There were no treatment-related complications during the follow-up period. Conclusions Gamma Knife surgery should be considered as a primary, combined, or additional treatment option for CSDAVF in selected cases, such as when the lesion is a low-flow shunt without cortical venous drainage. For those selected cases, GKS alone may suffice as the primary treatment method when combined with close monitoring of ocular symptoms and intraocular pressure.

scholarly journals Study of Dural Arteriovenous Fistula Drains into Leptomeningeal Vein without Sinus Interposition

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 127-134 ◽  
Author(s):  
T. Kawaguchi ◽  
M. Nakatani ◽  
T. Kawano
Keyword(s):  
Emergency Treatment ◽  
Superior Sagittal Sinus ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Dural Arteriovenous Fistulas ◽  
Cranial Fossa ◽  
Venous Ischemia

We evaluated dural arteriovenous fistulas (DAVF) drains into leptomeningeal vein (LMV) without the venous sinus interposition. This type of DAVF contained the extra-sinusal type DAVF and the DAVF with so-called pure leptomeningeal venous drainage (PLMVD). We studied 15 patients with DAVF that flows into LMVD without passing into the sinus. The subjects were 5 patients with DAVF in the anterior cranial fossa, 2 with DAVF in the tentorium cerebelli, and 3 with DAVF in the craniocervical junction as extra-sinusal type DAVF and 3 with DAVF in the transverse sigmoid sinus and 2 with DAVF in the superior sagittal sinus as DAVF with PLMVD. This type appears to take a very aggressive course. The arterial pressure of the shunt is directly applied to LMV, which causes bending and winding of the vein, eventually varices, inducing intracranial haemorrhage or venous ischemia in the LMV reflux area. Emergency treatment should be performed as soon as possible. Although it is recognized that interruption of the draining vein is very effective, treatment methods such as TAE, direct surgery, and g knife treatment, or their combinations should be carefully chosen for each case.

scholarly journals Dural Arteriovenous Shunt Development in Patients with Vein of Galen Malformation

2014 ◽  
Vol 20 (6) ◽  
pp. 781-790 ◽  
Author(s):  
Srinivasan Paramasivam ◽  
Yasunari Niimi ◽  
Dan Meila ◽  
Alejandro Berenstein
Keyword(s):  
Dura Mater ◽  
Endovascular Embolization ◽  
External Carotid ◽  
Vein Of Galen ◽  
Arteriovenous Fistulas ◽  
Sprouting Angiogenesis ◽  
Multi Stage ◽  
Dural Arteriovenous Shunt ◽  
Age Range

Dural arteriovenous fistulas (DAVF) associated with our series of patients with vein of Galen malformations (VOGM) are analyzed and discussed. We retrospectively analyzed 87 consecutive cases of VOGM treated between May 2002 and December 2011 and identified 26 patients with DAVF. We gathered information from the clinical case records, angiographic images, MRI on presentation and during follow-up. The findings were analyzed to aid discussion. Among 87 patients treated by multi-stage endovascular embolization, age range from newborn to 19 years, 26 (30%) had DAVF. In seven patients (8%), DAVF were found on initial angiogram and were all into the VOGM. Nineteen (21%) DAVF found on follow-up angiograms were all into the VOGM and distant locations. Sprouting and non-sprouting angiogenesis resulted in the formation of a network of vessels around partially thrombosed VOGM, recruiting blood from the surrounding dura mater resulting in a secondary network on the dura mater supplied by the blood vessels of dura mater in the region or from its natural collaterals. Embolization targeting DAVFs was done in 13 (52%) with complete cure in eight (32%) and recurrence in five (20%). Among 12 non-embolized patients (48%), eight (32%) had spontaneous regression with continued treatment of VOGM. In others, the DAVF either remained stable or progressed. DAVF associated with VOGM represent the dural response to angiogenic stimuli. They are observed to regress spontaneously or mature while continuing to treat the primary feeders of VOGM. It is important to include the external carotid system during angiograms. Persistent DAVF with residual VOGM that do not have access though the pial vessels are used as a conduit to treat the dural shunt and to achieve obliteration of residual VOGM at later stages of treatment.

Sign in / Sign up

Export Citation Format

Share Document