scholarly journals Transverse dural arteriovenous fistula with bilateral sigmoid sinus stenosis treated with via transarterial embolization and venous stent placement: case report

2021 ◽  
Author(s):  
Zeran Yu ◽  
Hai Song ◽  
Jiang Long ◽  
Yiqiang Cao ◽  
Yonggang Wang ◽  
...  
Keyword(s):  
Rare Case ◽  
Transarterial Embolization ◽  
Previous Treatment ◽  
Sigmoid Sinus ◽  
Cerebral Veins ◽  
Cerebrovascular Disorder ◽  
Arteriovenous Fistulas ◽  
Obvious Benefit ◽  
Meningeal Arteries ◽  
Sinus Stenosis

Abstract BackgroundDural arteriovenous fistulas (DVAF) is a cerebrovascular disorder due to abnormal connections within meningeal arteries and cerebral veins. It is usually associated with sinus stenosis.Case PresentationWe describe a case of DAVF with bilateral sigmoid sinus stenosis successfully treated via transarterial embolization and unilateral stenting.ConclusionThe author reported a rare case of DAVF associated with with bilateral sigmoid sinus stenosis. Direct embolization with catheterization of contralateral MMA may by an alternative way to treat partial embolized DAVF, when main feeding arteries were occluded due to previous treatment. Unilateral sinus recanalization for bilateral sinus narrows could also obtain obvious benefit.

scholarly journals Improvement of Depression after Treatment of Dural Arteriovenous Fistula: A Case Report and a Review

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Minoru Nakagawa ◽  
Kenji Sugiu ◽  
Koji Tokunaga ◽  
Chihoko Sakamoto ◽  
Kenjiro Fujiwara
Keyword(s):  
Arteriovenous Fistula ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Sigmoid Sinus ◽  
Local Hospital ◽  
Emissary Vein ◽  
Arteriovenous Fistulas ◽  
Mastoid Emissary Vein ◽  
Dural Arteriovenous Fistulas ◽  
Gerstmann’S Syndrome

Patients with dural arteriovenous fistulas (DAVFs) in the transverse-sigmoid sinus suffer from several symptoms: bruit, headache, visual impairment, and so on. But depression is rare in patients with DAVF. The authors reported a rare case presenting the improvement of depression after the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

The Strategy of Dural Arteriovenous Fistula with Isolated Sinus

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 113-116 ◽  
Author(s):  
O. Masuo ◽  
T. Terada ◽  
M. Tsuura ◽  
Y. Kinoshita ◽  
H. Yokote ◽  
...  
Keyword(s):  
Transient Ischemic Attack ◽  
Dural Arteriovenous Fistula ◽  
Superior Sagittal Sinus ◽  
Transarterial Embolization ◽  
Sigmoid Sinus ◽  
Arteriovenous Fistulas ◽  
Sagittal Sinus ◽  
Initial Symptoms ◽  
Dural Arteriovenous Fistulas ◽  
Ischemic Attack

We treated 7 cases of dural arteriovenous fistulas (dAVF) with isolated sinus by transvenous direct embolization. The fistulas located in the transverse-sigmoid sinus in 5 cases, superior sagittal sinus in 1 case and transverse-sigmoid and superior sagittal sinus in 1 case. The initial symptoms were generalized convulsion in 2 cases, disturbed consciousness in 1 case, tinnitus in 2 cases and transient ischemic attack in 2 cases. We performed sinus packing with coils in all cases following transarterial embolization. All patients improved neurologically after the treatments and AVFs completely disappeared in all cases.

scholarly journals Dural Sinus Malformation with Dural Arteriovenous Fistula

2001 ◽  
Vol 7 (4) ◽  
pp. 319-323 ◽  
Author(s):  
C. Kwong Yau ◽  
H. Alvarez ◽  
P. Lasjaunias
Keyword(s):  
Natural History ◽  
Arteriovenous Fistula ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Jugular Bulb ◽  
High Flow ◽  
Sigmoid Sinus ◽  
Dural Sinus ◽  
Dural Sinus Malformation

A rare case of dural sinus malformation with dural arteriovenous fistula in an infant is presented. Presenting symptom was progressive macrocrania without hydrocephalus. A high flow arteriovenous of the sigmoid sinus associated with jugular bulb diaphragm was demonstrated. Reflux in the intracranial sinus was present. The shunt was successfully occluded by transarterial embolization. The natural history and treatment strategy are discussed.

scholarly journals Dural Sinus Malformation with Dural Arteriovenous Fistula

2001 ◽  
Vol 7 (3) ◽  
pp. 231-236 ◽  
Author(s):  
C.K. Yau ◽  
H. Alvarez ◽  
P. Lasjaunias
Keyword(s):  
Natural History ◽  
Arteriovenous Fistula ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Jugular Bulb ◽  
High Flow ◽  
Sigmoid Sinus ◽  
Dural Sinus ◽  
Dural Sinus Malformation

A rare case of dural sinus malformation with dural arteriovenous fistula in an infant is presented. Presenting symptom was progressive macrocrania without hydrocephalus. A high flow AVS of the sigmoid sinus associated with jugular bulb diaphragm was demonstrated. Reflux in the intracranial sinus was present. The shunt was successfully occluded by transarterial embolization. The natural history and treatment strategy are discussed.

Direct packing of the isolated sinus in patients with dural arteriovenous fistulas of the transverse—sigmoid sinus

1998 ◽  
Vol 88 (3) ◽  
pp. 449-456 ◽  
Author(s):  
Shunro Endo ◽  
Naoya Kuwayama ◽  
Akira Takaku ◽  
Michiharu Nishijima
Keyword(s):  
Transarterial Embolization ◽  
Blood Gases ◽  
Venous Drainage ◽  
Sigmoid Sinus ◽  
Blood Gas ◽  
Content Type ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Sinus Pressure ◽  
Fine Print

Object. The goal of this study was to evaluate the efficacy of direct packing of the isolated sinus (occluded both distally and proximally) in patients with dural arteriovenous fistulas (AVFs) of the transverse—sigmoid sinus. Methods. Eight patients were included in this study. There were seven men and one woman, ranging in age from 47 to 75 years (mean 60.4 years). Five patients presented with intracranial hemorrhage or venous infarction, one with convulsions, and two with pulsatile tinnitus. Prominent retrograde cortical venous drainage due to sinus isolation was angiographically demonstrated in all patients. All patients were treated by a small craniotomy and direct sinus packing with microcoils; the procedure was performed with the aid of digital subtraction angiography. Five patients were pretreated with transarterial embolization to reduce arterial inflow before the procedure, and intrasinus pressure and sinus blood gases were monitored throughout the operation. Postsurgery, the dural AVF was completely obliterated in all patients. The sinus pressure was 29 to 58% of systemic blood pressure, and sinus blood gas levels were purely arterial before packing. There was no morbidity related to direct sinus packing; however, one patient died as a result of acute myocardial infarction. Over a follow-up period ranging from 1 to 5 years, a faint asymptomatic dural AVF recurred in one patient on the cortex adjacent to the occluded sinus but regressed spontaneously within 1 year. Conclusions. Direct sinus packing was found to be highly effective for the treatment of dural AVFs that empty into the isolated sinus. Measurement of changes in sinus pressure and sinus blood gas levels was useful for monitoring the progress of direct sinus packing.

scholarly journals Long-term angiographic results of endovascularly “cured” intracranial dural arteriovenous fistulas

2016 ◽  
Vol 124 (4) ◽  
pp. 1123-1127 ◽  
Author(s):  
Sudheer Ambekar ◽  
Brandon G. Gaynor ◽  
Eric C. Peterson ◽  
Mohamed Samy Elhammady
Keyword(s):  
Cerebral Veins ◽  
Embolic Material ◽  
Arteriovenous Fistulas ◽  
Patient Demographics ◽  
Dural Arteriovenous Fistulas ◽  
Angiographic Data ◽  
Meningeal Arteries ◽  
Feeding Vessels

OBJECT Dural arteriovenous fistulas (DAVFs) are complex lesions consisting of abnormal connections between meningeal arteries and dural venous sinuses and/or cerebral veins. The goal of treatment is surgical or endovascular occlusion of the fistula or fistulous nidus or at least the disconnection of the feeding vessels and the draining veins. Delayed angiographic data on previously embolized dural fistulas is lacking. The authors report their experience and the long-term angiographic results with embolization of intracranial DAVF using Onyx. METHODS All cases of DAVF treated primarily with Onyx at the authors’ institution from 2006 to 2013 were retrospectively reviewed. Patient demographics, fistula characteristics, embolization details, and angiographic follow-up were analyzed. RESULTS Fifty-eight patients with DAVFs were treated during the study period. Twenty-two patients were treated with open surgery with or without prior embolization. Thirty-six patients were treated with embolization alone, of whom 26 underwent an attempt at curative embolization and are the subject of this review. All but 2 of these patients were treated in a single session. Angiographic “cure” was achieved in all cases following treatment. Follow-up angiography was performed in 21 patients at a mean of 14 months after treatment (range 2–39 months). Asymptomatic angiographic recurrence of the fistula was evident in 3 of the 21 patients (14.3%). On reviewing the procedural angiograms of the cases in which the DAVFs recurred, it was observed that the Onyx cast did not reach the venous portion in 1 case, whereas it did reach the vein in the other 2 cases. CONCLUSIONS Recurrence following initial angiographic cure of DAVF is not uncommon. Incomplete penetration of the embolic material into the proximal portion of the venous outlet may lead to delayed recurrence. Long-term angiographic follow-up is highly recommended.

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.

Results of 1940 embolizations for dural arteriovenous fistulas: Japanese Registry of Neuroendovascular Therapy (JR-NET3)

2020 ◽  
Vol 133 (1) ◽  
pp. 166-173 ◽  
Author(s):  
Masafumi Hiramatsu ◽  
Kenji Sugiu ◽  
Tomohito Hishikawa ◽  
Shingo Nishihiro ◽  
Naoya Kidani ◽  
...  
Keyword(s):  
Risk Factors ◽  
Data Extraction ◽  
Transarterial Embolization ◽  
Complication Rates ◽  
Multicenter Observational Study ◽  
Arteriovenous Fistulas ◽  
Emergency Procedures ◽  
Dural Arteriovenous Fistulas ◽  
Nature Frequency ◽  
Independent Risk Factors

OBJECTIVEEmbolization is the most common treatment for dural arteriovenous fistulas (dAVFs). A retrospective, multicenter observational study was conducted in Japan to clarify the nature, frequency, and risk factors for complications of dAVF embolization.METHODSPatient data were derived from the Japanese Registry of Neuroendovascular Therapy 3 (JR-NET3). A total of 40,169 procedures were registered in JR-NET3, including 2121 procedures (5.28%) in which dAVFs were treated with embolization. After data extraction, the authors analyzed complication details and risk factors in 1940 procedures performed in 1458 patients with cranial dAVFs treated with successful or attempted embolization.RESULTSTransarterial embolization (TAE) alone was performed in 858 cases (44%), and transvenous embolization (TVE) alone was performed in 910 cases (47%). Both TAE and TVE were performed in one session in 172 cases (9%). Complications occurred in 149 cases (7.7%). Thirty-day morbidity and mortality occurred in 55 cases (2.8%) and 16 cases (0.8%), respectively. Non–sinus-type locations, radical embolization as the strategy, procedure done at a hospital that performed dAVF embolization in fewer than 10 cases during the study period, and emergency procedures were independent risk factors for overall complications.CONCLUSIONSComplication rates of dAVF embolization in Japan were acceptable. For better results, the risk factors identified in this study should be considered in treatment decisions.

scholarly journals Cerebral Venous Thrombosis: What's New?

2021 ◽  
Vol 41 (01) ◽  
pp. 025-030
Author(s):  
Diana Aguiar de Sousa
Keyword(s):  
Young Adults ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Cerebral Veins ◽  
Cerebrovascular Disorder ◽  
Recent Advances ◽  
Children And Young Adults

AbstractThrombosis of the cerebral veins and sinuses (CVT) is a distinct cerebrovascular disorder that, unlike arterial stroke, most often affects children and young adults, especially women. In this review, we will summarize recent advances on the knowledge of patients with CVT.

Abstract 1122‐000232: The Importance of Performing Venous Pressure Measurements Following Venous Sinus Stenting for Idiopathic Intracranial Hypertension

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Yazan Radaideh
Keyword(s):  
Pressure Gradient ◽  
Intracranial Hypertension ◽  
Stent Placement ◽  
Idiopathic Intracranial Hypertension ◽  
Venous Pressure ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
Pressure Measurements ◽  
Sinus Stenosis ◽  
The Right

Introduction : Although venous sinus stenting is an established treatment for medically refractory idiopathic intracranial hypertension, a subset of patients shows little or no improvement of symptoms after stenting. While this could be related to a number of factors, failure to sufficiently address the pressure gradient is one that can be recognized during the treatment procedure. We describe two patients who had a persistent venous pressure gradient after stent placement. Once identified, a second stent was placed with subsequent resolution of the pressure gradient. Methods : This retrospective chart review identified patients at a single institution who underwent venous sinus stenting and required immediate placement of a second venous sinus stent for a persistent pressure gradient. Results : Two patients with refractory idiopathic intracranial hypertension underwent cerebral angiography with venous manometry. In the first patient, unilateral venous sinus stenosis was present with a maximum pressure of 50 mmHg, which only decreased to 30 mmHg after placement of a right transverse‐sigmoid sinus stent. Subsequent manometry revealed a persistent gradient between the superior sagittal sinus and the right transverse sinus, which resolved after placement of a second stent in this location. In the second patient, bilateral stenosis was observed at the transverse‐sigmoid sinus junction; the maximum venous pressure was 40 mmHg, and a gradient of 30 mmHg was measured at the right transverse‐sigmoid junction, where a venous sinus stent was placed. Venous sinus pressure measurements performed immediately after the stent placement demonstrated a persistent pressure gradient of 20 mmHg in the contralateral transverse‐sigmoid sinus junction, which resolved after contralateral stent placement. Both patients showed sustained improvement in their symptoms at 1 year follow up. Conclusions : In some patients with idiopathic intracranial hypertension and venous sinus stenosis, a single stent may not sufficiently reduce the pressure gradient. A second stent may be required; however, this is only detectable with post‐stent pressure measurements. Performing manometry after stent placement should be routinely performed in order to detect persistent venous pressure gradient.

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