scholarly journals Efficacy of intra-arterial indocyanine green angiography for the microsurgical treatment of dural arteriovenous fistula: A case report

2020 ◽  
Vol 11 ◽  
pp. 46
Author(s):  
Keisuke Sasaki ◽  
Hidenori Endo ◽  
Kuniyasu Niizuma ◽  
Yasuo Nishijima ◽  
Shinichiro Osawa ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Transverse Sinus ◽  
Vascular Lesions ◽  
Occipital Artery ◽  
Feeding Artery ◽  
Cortical Vein ◽  
History Of

Background: In this study, we report a case of dural arteriovenous fistula (dAVF) that was successfully treated using intra-arterial indocyanine green (IA-ICG) videoangiography during open surgery. Moreover, the findings of IA-ICG videoangiography were compared with those of intraoperative digital subtraction angiography (DSA). Case Description: A 72-year-old male patient with a history of hypertension, hyperlipidemia, and thrombocytosis presented with generalized seizure. DSA revealed Cognard Type III dAVF in the superior wall of the left transverse sinus, which was fed by a single artery (the left occipital artery [OA]) and drained into a single vein (the left temporal cortical vein), without drainage into a venous sinus. Since transarterial embolization was considered challenging due to the tortuosity of the left OA, surgical interruption of the shunt was performed by craniotomy. After excising the feeding artery, we were unable to observed dAVF on intraoperative DSA. However, IA-ICG videoangiography revealed the remaining shunt, which was fed by the collateral route from the feeding artery. The shunting point and draining vein were then surgically resected to eliminate the shunt. The shunt was not observed during the second IA-ICG videoangiography conducted after resection. Conclusion: ICG videoangiography is a better method compared with DSA in terms of visualizing fine vascular lesions. In contrast to the typical intravenous administration, selective IA-ICG can be repeatedly injected at a minimal dose. IA-ICG is a useful intraoperative tool that can be used to evaluate the elimination of the dAVF.

scholarly journals Utility of targeted balloon protection of the venous sinus for endovascular treatment of dural arteriovenous fistula by transarterial embolization with Onyx: A case report and literature review

2021 ◽  
Vol 12 ◽  
pp. 340
Author(s):  
Masahiko Tagawa ◽  
Akihiro Inoue ◽  
Kentaro Murayama ◽  
Shirabe Matsumoto ◽  
Saya Ozaki ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Successful Treatment ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Venous Drainage ◽  
Venous Sinus ◽  
Occipital Artery ◽  
Balloon Protection ◽  
Sinus Flow

Background: Onyx has already been reported as an effective and safe agent in transarterial embolization of cranial dural arteriovenous fistula (d-AVF). However, successful treatment is related to not only complete shunt obliteration but also preservation of a normal route of venous drainage. Here, we present a case of transverse sigmoid d-AVF in which successful treatment was achieved by transarterial Onyx embolization with targeted balloon protection of the venous drainage. Case Description: A 70-year-old man presented with a 3-month history of tinnitus in the left ear and mild headache. Magnetic resonance imaging (MRI) showed a cluster of abnormal blood vessels in the area of the left transverse sinus (TS)-sigmoid sinus (SS) junction. Cerebral angiography demonstrated a Cognard type IIa d-AVF at the left TS-SS junction, supplied mainly by vessels such as the left middle meningeal artery, left occipital artery, and left meningohypophyseal trunk. In the venous phase, the ipsilateral TS-SS was recognized as a functional sinus and the left vein of Labbe drained into the TS near the drainage channel. Based on these findings, we decided to perform endovascular treatment under a transarterial approach with Onyx using targeted balloon protection of the venous sinus to protect against Onyx migration and preserve antegrade sinus flow. The patient recovered well without sequelae, and follow-up MRI 12 months later showed complete disappearance of the d-AVF. Conclusion: This treatment strategy using targeted balloon protection may be very useful to preserve antegrade sinus flow in patients with Cognard type IIa d-AVF.

scholarly journals Transforaminal approach for cerebral dural arteriovenous fistula embolization

2015 ◽  
Vol 21 (2) ◽  
pp. 240-243
Author(s):  
Ramsey Ashour ◽  
Sachin Pandey ◽  
Mohammad Ali Aziz-Sultan
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transverse Sinus ◽  
Occipital Artery ◽  
Ct Guided ◽  
Direct Puncture ◽  
Transforaminal Approach ◽  
Ct Angiogram ◽  
Artery Branch ◽  
Arterial Branch

A transverse sinus dural arteriovenous fistula (DAVF) not easily accessible by standard transfemoral (transarterial or transvenous) endovascular approaches is presented. An enlarged transosseous retromastoid foramen harboring the occipital artery branch feeding the lesion was identified on CT angiogram (CTA). Curative Onyx embolization was achieved via percutaneous CT-guided direct puncture of the transosseous occipital arterial branch followed by microcatheter navigation through the needle distally towards the site of the fistula.

scholarly journals Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula

2020 ◽  
Vol 2020 (10) ◽  
Author(s):  
Shuhei Kawabata ◽  
Hajime Nakamura ◽  
Takeo Nishida ◽  
Masatoshi Takagaki ◽  
Nobuyuki Izutsu ◽  
...  
Keyword(s):  
Blood Flow ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Transarterial Embolization ◽  
Anterior Cranial Fossa ◽  
Maxillary Artery ◽  
Flow Reduction ◽  
Cranial Fossa ◽  
Embolic Materials

ABSTRACT Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, high blood flow from the internal maxillary artery (IMA) often impedes penetration of embolic materials into the shunt pouch. Therefore, reducing blood flow from the IMA before embolization can increase the success rate. In the present case, to reduce blood flow from branches of the IMA, we inserted surgical gauze infiltrated with xylocaine and epinephrine into bilateral nasal cavities. Using this method, we achieved curative TAE with minimal damage to the nasal mucosa. Transnasal flow reduction is an easy, effective and minimally invasive method. This method should be considered in the endovascular treatment of ACF–dAVF, especially in patients with high blood flow from theIMA.

Gradual dilatation of an occluded transverse sinus associated with dural arteriovenous fistula after balloon angioplasty with sinus packing: A case report

2021 ◽  
pp. 197140092110415
Author(s):  
Takuya Osuki ◽  
Hiroyuki Ikeda ◽  
Tomoko Hayashi ◽  
Silsu Park ◽  
Minami Uezato ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Balloon Angioplasty ◽  
Dural Arteriovenous Fistula ◽  
Executive Dysfunction ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Sigmoid Sinus ◽  
Shunt Flow ◽  
Symptomatic Epilepsy ◽  
The Right

Background There is no consensus as to whether balloon angioplasty alone or stent placement is effective for sinus occlusion associated with dural arteriovenous fistula (DAVF). Herein, we first report a case of transverse sinus occlusion associated with DAVF in which gradual sinus dilatation was observed after balloon angioplasty with embolization of the affected sinus with shunt flow. Case presentation A 69-year-old man presented with executive dysfunction. Magnetic resonance imaging revealed left transverse sinus–sigmoid sinus DAVF with occlusion of the left jugular vein and right transverse sinus. Before endovascular treatment, the patient had symptomatic epilepsy and subarachnoid hemorrhage. Retrograde leptomeningeal venous drainage disappeared with packing of the left transverse sinus–sigmoid sinus. Subsequently, balloon angioplasty of the right occluded transverse sinus was performed to maintain the normal venous drainage and remaining shunt outflow. Dilatation of the right transverse sinus was poor immediately after surgery. However, angiography after 10 days and 6 months revealed gradual dilatation of the right transverse sinus. Conclusion Sinus occlusion, which is thought to be caused by sinus hypertension associated with DAVF rather than chronic organized thrombosis or thrombophilia, may dilate over time after balloon angioplasty and shunt flow reduction if occluded sinus is necessary for facilitating normal venous drainage.

scholarly journals Microsurgery of Spinal Dural Arteriovenous Fistula Using Indocyanine Green Video Angiography: 2-Dimensional Operative Video

2018 ◽  
Vol 17 (1) ◽  
pp. 110-110
Author(s):  
Kunio Yokoyama ◽  
Yasuaki Okuda ◽  
Makoto Yamada ◽  
Hidekazu Tanaka ◽  
Yutaka Ito ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Spinal Dural Arteriovenous Fistula

Indocyanine Green Videoangiography “In Negative”: Definition and Usefulness in Intracranial Dural Arteriovenous Fistulae

2013 ◽  
Vol 73 (suppl_1) ◽  
pp. ons86-ons92 ◽  
Author(s):  
Juan Antonio Julián ◽  
Pablo Miranda Lloret ◽  
Fernando Aparici Robles ◽  
Andrés Beltrán Giner ◽  
Carlos Botella Asunción
Keyword(s):  
Indocyanine Green ◽  
Arteriovenous Fistula ◽  
Arteriovenous Malformations ◽  
Dural Arteriovenous Fistula ◽  
Simple Procedure ◽  
Vascular Pathology ◽  
Digital Subtraction ◽  
Indocyanine Green Videoangiography ◽  
Arteriovenous Fistulae ◽  
Intracranial Dural Arteriovenous Fistulae

Abstract BACKGROUND: Indocyanine green videoangiography (IGV) raises important limitations when we use it in vascular pathology, especially in cases with arterialization of the venous system such as arteriovenous malformations and fistulae. OBJECTIVE: Our objective was to provide a simple procedure that overcomes the limitations of conventional IGV. We define IGV in negative (IGV-IN), so-called because, in its first phase, the vessel to analyze is clipped, and we report 3 cases of intracranial dural arteriovenous fistulae treated with this procedure. METHODS: In 2011, we applied IGV-IN to 3 patients at our center with Borden type III intracranial arteriovenous fistulae. RESULTS: In all 3 cases, IGV-IN enabled both diagnosis and post-dural arteriovenous fistula exclusion control in 1 integrated procedure no longer than 1 minute, requiring only 1 visualization. CONCLUSION: IGV-IN is an improvement over the conventional IGV method and is able to provide more information in a shorter period of time. It is an intuitive and highly visual procedure, and, more importantly, it is reversible. Studies with larger samples are necessary to determine whether IGV-IN can further reduce the need for postoperative digital subtraction angiography.

scholarly journals Left temporal craniotomy and direct microcatheterization of the middle meningeal artery for treatment of a complex temporal dural arteriovenous fistula

2019 ◽  
Vol 46 (Suppl_2) ◽  
pp. V8
Author(s):  
Daniel M. S. Raper ◽  
Nasser Mohammed ◽  
M. Yashar S. Kalani ◽  
Min S. Park
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Treatment Approach ◽  
Transarterial Embolization ◽  
Middle Meningeal Artery ◽  
Intraoperative Angiography ◽  
Arteriovenous Fistulae ◽  
Posterior Division ◽  
Technical Considerations ◽  
Meningeal Artery

The preferred method for treating complex dural arteriovenous fistulae of the transverse and sigmoid sinuses is via endovascular, transarterial embolization using liquid embolysate. However, this treatment approach mandates access to distal dural feeding arteries that can be technically challenging by standard endovascular approaches. This video describes a left temporal craniotomy for direct stick microcatheterization of an endovascularly inaccessible distal posterior division of the middle meningeal artery for embolization of a complex left temporal dural arteriovenous fistula. The case was performed in the hybrid operative suite with biplane intraoperative angiography. Technical considerations, operative nuances, and outcomes are reviewed.The video can be found here: https://youtu.be/Dnd4yHgaKcQ.

scholarly journals Multiple aneurysms on the subarcuate artery arising from the anterior inferior cerebellar artery in a patient with a Borden type I transverse-sigmoid dural arteriovenous fistula manifesting as subarachnoid hemorrhage: A case report

2018 ◽  
Vol 25 (1) ◽  
pp. 90-96 ◽  
Author(s):  
Tomoaki Suzuki ◽  
Kouichirou Okamoto ◽  
Nobuyuki Genkai ◽  
Yasushi Ito ◽  
Hiroshi Abe
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Anterior Inferior Cerebellar Artery ◽  
Type I ◽  
Feeding Artery ◽  
Multiple Aneurysms ◽  
Arteriovenous Shunts ◽  
Cerebellar Artery ◽  
Subarcuate Artery

Background Peripheral anterior inferior cerebellar artery (AICA) aneurysms are rare and commonly associated with vascular malformations, such as cerebellar arteriovenous malformations (AVMs). We present a case wherein multiple AICA feeding aneurysms on the subarcuate artery as a feeding artery of a Borden type I transverse-sigmoid dural arteriovenous fistula (dAVF) manifested as subarachnoid hemorrhage. Case description A 67-year-old woman presented with acute severe headache. Brain computed tomography (CT) demonstrated subarachnoid hemorrhage mainly in the posterior fossa. A transverse-sigmoid dAVF was detected on magnetic resonance angiography (MRA) and three-dimensional-CT angiography (3D-CTA), with no cortical venous reflex. The patient underwent conventional angiography, which showed multiple aneurysms on a small branch of the AICA, feeding a transverse-sigmoid dAVF (Borden type I). The AICA aneurysms seemed flow dependent and ruptured owing to high-flow arteriovenous shunts through the dAVF. Based on the source images of the MRA, the small artery arising from the AICA was considered the subarcuate artery, and it was confirmed on 3D-CTA after the artery was successfully embolized with Onyx without any complications. Multiple aneurysms on the subarcuate artery are extremely rare, and the artery has not been identified as a feeding artery of the transverse-sigmoid dAVF. Conclusion A rare case of multiple ruptured aneurysms on the subarcuate artery was reported in a patient with a Borden type I dAVF at the transverse-sigmoid sinuses manifesting as subarachnoid hemorrhage. Onyx embolization of the parent artery occlusion was feasible and useful in treating this type of feeding artery aneurysm of the AICA with a dAVF.

Sign in / Sign up

Export Citation Format

Share Document