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.

scholarly journals Cranial venous sinus dominance: what to expect? Analysis of 100 cerebral angiographies

2017 ◽  
Vol 75 (5) ◽  
pp. 295-300 ◽  
Author(s):  
Matheus Augusto Pinto Kitamura ◽  
Leonardo Ferraz Costa ◽  
Danilo Otávio de Araújo Silva ◽  
Laécio Leitão Batista ◽  
Maurus Marques de Almeida Holanda ◽  
...  
Keyword(s):  
Internal Jugular Vein ◽  
Superior Sagittal Sinus ◽  
Jugular Vein ◽  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
Venous Sinuses ◽  
Sagittal Sinus ◽  
Cranial Venous Sinuses ◽  
And Gender ◽  
Dominance Pattern

ABSTRACT We report an analysis of the cranial venous sinuses circulation, emphasizing morphological and angiographic characteristics. Methods Data of 100 cerebral angiographies were retrospectively analyzed (p = 0.05). Results Mean age was 56.3 years, 62% female and 38% male. Measurements and dominance are shown in the Tables. There was no association between age or gender and dominance. Right parasagittal division of the superior sagittal sinus was associated with right dominance of the transverse sinus, sigmoid sinus and internal jugular vein; and left parasagittal division of the superior sagittal sinus was associated with left dominance of the transverse sinus, sigmoid sinus and internal jugular vein. Conclusion A dominance pattern of cranial venous sinuses was found. Age and gender did not influence this pattern. Angiographic findings, such as division of the superior sagittal sinus, were associated with a pattern of cranial venous dominance. We hope this article can add information and assist in preoperative venous analysis for neurosurgeons and neuroradiologists.

scholarly journals Analysis of the best therapeutic alternative for intracranial dural arteriovenous malformations

2005 ◽  
Vol 63 (3a) ◽  
pp. 605-613 ◽  
Author(s):  
César de Paula Lucas ◽  
Mirto N. Prandini ◽  
José Guilherme Mendes Pereira Caldas
Keyword(s):  
Cavernous Sinus ◽  
Arteriovenous Malformations ◽  
Superior Sagittal Sinus ◽  
Sigmoid Sinus ◽  
Combined Method ◽  
Therapeutic Success ◽  
Therapeutic Alternative ◽  
Sagittal Sinus ◽  
Anterior Fossa ◽  
Transvenous Approach

The material for this research consisted of 93 patients with dural arteriovenous malformations (DAVMs) who were studied retrospectively with regards to therapeutic success and failure, who had undergone either neurosurgery, or embolization or a combination of both methods and whose disease was located in the cavernous sinus, the superior sagittal sinus, the transverse-sigmoid sinus of the anterior fossa and the tentorium. Thus, it was possible to arrive at the following conclusions: treatment of the DAVMs must be indicated, jointly, by an interventionist neuroradiologist and a neurosurgeon; DAVMs of the transverse-sigmoid sinus were better treated when a combination of both methods was used; DAVMs of the tentorium were also better treated with a combined method; the endovascular method ensured only a 50% chance of therapeutic success for DAVMs of the superior sagittal sinus; DAVMs of the cavernous sinus are better treated when the endovascular method was used with a transvenous approach, relative to the transarterial approach.

MRA Evidence of Superior Sagittal Sinus — Torcular Herophili Divisions in a New Type of Occipital Sinus

2009 ◽  
Vol 22 (4) ◽  
pp. 378-380
Author(s):  
P. La Montanara ◽  
G. Crisi
Keyword(s):  
Superior Sagittal Sinus ◽  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
Marginal Sinus ◽  
Occipital Sinus ◽  
Sagittal Sinus ◽  
New Type ◽  
The Right ◽  
Patent Right

We describe a new type of occipital sinus: absence (or hypoplasy) of the right transverse sinus, patent right sigmoid sinus and a well formed left occipital sinus draining into the left marginal sinus. The lateral and occipital sinus variations were classified into five groups by Kalbag. This classification was modified in 1980 by Dora and Zileli. We speculate on the possible MRA evidence of “divisions” of the superior sagittal sinus (SSS), as reported by Shao et Al (2009) who examined the lumen of the SSS and torcular Herophili with the aid of an endoscope.

Superior sagittal sinus thrombosis complicating neck dissection

2010 ◽  
Vol 124 (10) ◽  
pp. 1126-1128
Author(s):  
D J Howe ◽  
M J Henderson ◽  
I Ahmad
Keyword(s):  
Neck Dissection ◽  
Internal Jugular Vein ◽  
Superior Sagittal Sinus ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Rare Complication ◽  
Elective Neck Dissection ◽  
Sagittal Sinus ◽  
Sagittal Sinus Thrombosis ◽  
Superior Sagittal Sinus Thrombosis

AbstractObjective:To report a superior sagittal sinus thrombosis occurring as a rare complication of neck dissection, and to present a review of published literature.Case report:A 42-year-old man underwent an elective neck dissection for a tumour stage 2, node stage 2b, tonsillar squamous cell carcinoma, prior to chemoradiotherapy. During surgery, the right internal jugular vein was sacrificed as part of the resection, as tumour was adherent to it. Two weeks after surgery, the patient was readmitted with seizures. Subsequent computed tomography and magnetic resonance venography confirmed a superior sagittal sinus thrombosis. The patient was subsequently anticoagulated and underwent radiotherapy without further complication. A review of pre-operative imaging indicated a dominant internal jugular vein, ligation of which may have been a factor in the subsequent sagittal sinus thrombosis.Conclusion:Superior sagittal sinus thrombosis following neck dissection is a rare occurrence, with little reported in the literature. Dominant internal jugular vein anatomy may be evident on pre-operative imaging. An awareness of this complication may be helpful to surgeons contemplating sacrifice of the internal jugular vein.

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 Treatment of Intracranial Venous Occlusive Disease with Sigmoid Sinus Angioplasty and Stent Placement in a Case of Infantile Multifocal Dural Arteriovenous Shunts

2001 ◽  
Vol 7 (1) ◽  
pp. 51-60 ◽  
Author(s):  
P. Vilela ◽  
R. Willinsky ◽  
K. terBrugge
Keyword(s):  
Stent Placement ◽  
Venous Pressure ◽  
Jugular Bulb ◽  
Sigmoid Sinus ◽  
Occlusive Disease ◽  
Dural Sinus ◽  
Arteriovenous Shunts ◽  
Dural Arteriovenous Shunts ◽  
The Right ◽  
Transvenous Approach

The infantile dural arteriovenous shunts are multifocal involving different dural sinuses and progress to an occlusive venopathy with sigmoid sinus and/or jugular bulb stenosis and subsequent occlusion. We report a successful angioplasty and stent placement of a sigmoid sinus — jugular bulb stenosis due to venous occlusive disease in a patient with infantile dural arteriovenous shunts. A five-year-old patient presented with status epilepticus due to severe venous congestive encephalopathy. The angiogram revealed multifocal dural arteriovenous shunts, occlusion of the right sigmoid sinus, absence of cavernous sinuses and significant stenosis of the left sigmoid sinus — jugular bulb. By transvenous approach, percutaneous transluminal balloon angioplasty and stent placement of the stenosed left sigmoid sinus — jugular bulb segment was performed. This resulted in a significant decrease of the venous pressure gradient across the stenosis and allowed a dramatic clinical recovery. Dural sinus angioplasty and stent placement appears to be a safe and effective procedure and should be considered in the treatment of the venous occlusive disease associated with infantile dural arteriovenous shunts.

scholarly journals A peculiar case of dural venous sinuses with resulting atypical bony markings in posterior cranial fossa

2017 ◽  
Vol 5 (6) ◽  
pp. 2830
Author(s):  
Gitanjali Khorwal ◽  
Sunita Kalra
Keyword(s):  
Right Hemisphere ◽  
Superior Sagittal Sinus ◽  
Transverse Sinus ◽  
Posterior Cranial Fossa ◽  
Undergraduate Medical Students ◽  
Venous Sinuses ◽  
Sagittal Sinus ◽  
Cranial Fossa ◽  
The Right ◽  
Dural Venous Sinuses

A paramedian or midline suboccipital approach for craniotomies and craniectomies is commonly employed for decompression or tumour resections from posterior cranial fossa. The reference for midline is taken as the line joining the nasion and inion on the surface of the skull which is the estimated position of superior sagittal sinus. In the interior, the internal occipital protuberance is the site of confluence of sinuses which presents a spectrum of variations. An unusual pattern of drainage of dural venous sinuses was observed at the site of customary confluence during routine dissection of head region for undergraduate medical students in a sixty-year-old female cadaver. The superior sagittal sinus continued as right transverse sinus as usual but it was connected to the left transverse sinus through a venous channel. There was no appreciable confluence of sinuses at this site. A prominent and atypical cerebellar process emerged from right hemisphere of cerebellum and projected between right transverse sinus and the venous channel connecting right and left transverse sinuses. In the posterior cranial fossa, the internal occipital crest was present on the left of midline separated from internal occipital protuberance. Another small ridge was present to the right of midline. A triangular fossa thus formed on the right side of internal occipital crest was occupied by the unusual prominent process emerging from the right hemisphere of cerebellum.Pre-operative assessment of dural venous sinuses is imperative before any surgical intervention especially around the confluence of the sinuses.

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