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.

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.

scholarly journals Transvenous microguidewire looping technique for breach of ipsilateral inferior petrosal sinus occlusions en route to cavernous sinus dural arteriovenous fistulas

2016 ◽  
Vol 22 (5) ◽  
pp. 590-595 ◽  
Author(s):  
Young Dae Cho ◽  
Jong Kook Rhim ◽  
Dong Hyun Yoo ◽  
Hyun-Seung Kang ◽  
Jeong Eun Kim ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Coil Embolization ◽  
Inferior Petrosal Sinus ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Embolic Materials ◽  
Transvenous Approach ◽  
Cure Rates ◽  
Guiding Catheter

Background and purpose Transarterial access to dural arteriovenous fistulas (dAVFs) has been popularized by device improvements and novel embolic materials. However, this approach is limited in the cavernous sinus (CS) because of related complications and low cure rates. Although a transvenous approach, via ipsilateral inferior petrosal sinus (IPS), may be more suitable for CS-dAVFs, microcatheter delivery is occasionally impeded by ipsilateral IPS occlusion. Described herein is a microguidewire looping method to breach such occlusions, thus enabling access to CS lesions. Methods A microcatheter is initially advanced into the IPS orifice, and a microguidewire is passed into the occluded IPS. Looping is easily achieved through the resistance met. With greater support of the guiding catheter, the microguidewire (still looped) is then advanced into the CS. When nearing the CS, the microcatheter is further reinforced, and it is navigated along the microguidewire into the CS. Results This technique was applied in 10 instances of CS-dAVF with ipsilateral IPS occlusion, enabling ipsilateral access to the CS. In eight cases (80%), microdevice advancement was successful, culminating in effective transvenous coil embolization. Clinical and radiologic outcomes in all patients were excellent, with no delayed post-procedural cranial palsies. Conclusion This microguidewire looping technique enables safe and effective entry into the CS during transvenous coil embolization of CS-dAVFs with ipsilateral IPS occlusion.

scholarly journals The Potentiality for Development of Multiple Dural Arteriovenous Fistulas after Ligation of the Internal Jugular Vein: A Case Report

2017 ◽  
Vol 4 (3) ◽  
pp. 71-73 ◽  
Author(s):  
Hirotaka Fudaba ◽  
Takeshi Kubo ◽  
Makoto Goda ◽  
Kenji Sugita ◽  
Masaki Morishige ◽  
...  
Keyword(s):  
Case Report ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

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 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.

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