Endovascular treatment of complex dural arteriovenous fistula using the dual-microcatheter technique

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Michael R. Levitt ◽  
Joshua W. Osbun ◽  
John D. Nerva ◽  
Louis J. Kim
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Jugular Bulb ◽  
Endovascular Embolization ◽  
Venous Hypertension ◽  
Lost To Follow Up ◽  
Onyx Copolymer

A 71-year-old woman presented with headache and dilated vessels on CTA. Angiography demonstrated a complex dural arteriovenous fistula with retrograde cortical venous hypertension, supplied by branches of internal and external carotids bilaterally into a fistulous pouch paralleling the left transverse and sigmoid sinuses, which was occluded at the jugular bulb. The patient refused treatment and was lost to follow-up, returning with sudden confusion and hemianopsia from left temporo-occipital hemorrhage. Transvenous endovascular embolization was performed using the dual-microcatheter technique with a combination of coiling and Onyx copolymer, completely occluding the sinus and fistula while preserving normal venous drainage.The video can be found here: http://youtu.be/u_4Oc7tSmDM.

scholarly journals Endovascular Treatment of a Dural Arteriovenous Fistula of the Transverse Sinus by Recanalisation, Angioplasty and Stent Deployment

2003 ◽  
Vol 9 (1) ◽  
pp. 65-69 ◽  
Author(s):  
W. Weber ◽  
B. Kis ◽  
J. Esser ◽  
P. Berlit ◽  
D. Kühne
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Venous Reflux ◽  
Stent Deployment ◽  
Total Occlusion ◽  
Cortical Venous Reflux

We report the endovascular treatment of a 40-year-old woman with bilaterally thrombosed transverse sinuses and a dural arteriovenous fistula (DAVF) causing cortical venous reflux by recanalization, angioplasty and stent deployment of the occluded sinus segment followed by occlusion of the DAVF by stent deployment in the fistulous segment. By recanalization of the occluded sinus we re-established normal anterograde venous drainage and eliminated the venous hypertension and cortical venous reflux. After the procedure, the patient was treated with aspirin and clopidogrel for three months. A follow-up examination showed total occlusion of the DAVF, patency of the sinus and a complete resolution of the clinical symptoms.

Reversal of Diffusion Restriction After Embolization of Dural Arteriovenous Fistula: Case Report

Neurosurgery ◽  
2010 ◽  
Vol 67 (4) ◽  
pp. E1147-E1151 ◽  
Author(s):  
Guilherme Dabus ◽  
Richard A Bernstein ◽  
Michael C Hurley ◽  
Ali Shaibani ◽  
Bernard R Bendok ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Rare Case ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Resonance Imaging ◽  
Diffusion Restriction ◽  
Magnetic Resonance Imaging Mri

Abstract BACKGROUND AND IMPORTANCE: We report a rare case of diffusion restriction caused by venous hypertension resulting from a dural arteriovenous fistula (DAVF) that completely reversed after successful embolization. CLINICAL PRESENTATION: A 54-year-old man presented with symptoms secondary to a DAVF. Magnetic resonance imaging (MRI) revealed left parieto-temporo-occipital diffusion restriction. The angiogram revealed a Cognard type III left lateral tentorial DAVF resulting in severe venous hypertension. Transarterial Onyx embolization was performed, resulting in angiographic cure of the fistula with normalization of the venous drainage in the left parieto-temporo-occipital region. A follow-up MRI examination performed 4 weeks after the embolization revealed resolution of the previously seen area of restricted diffusion. CONCLUSION: It is important to consider the possibility of diffusion restriction reversal, because misdiagnosis or the false assumption that irreversible cerebral infarction has occurred may inappropriately alter or delay the treatment of these aggressive lesions.

scholarly journals The remnant of primary head sinus found in the case of dural arteriovenous fistula: A case report

2016 ◽  
Vol 22 (4) ◽  
pp. 452-456 ◽  
Author(s):  
Katsuhiro Mizutani ◽  
Takenori Akiyama ◽  
Kazunari Yoshida
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Rare Condition ◽  
Venous Drainage ◽  
Petrous Bone ◽  
Jugular Bulb ◽  
Cone Beam ◽  
Middle Fossa ◽  
Rotational Angiography ◽  
Anatomic Information

In the embryo, the primary head sinus (PHS) is the first venous drainage channel in the craniocervical region. During embryonic development, this channel regresses and usually disappears completely; accordingly, a remnant of the PHS is an extremely rare condition and has been described in only a few previous studies. Here, we report a case of remnant of the PHS with a dural arteriovenous fistula (dAVF) in an adult. The remnant of the PHS had penetrated the petrous bone to run from the middle fossa to the jugular bulb and served as a drain for the middle fossa dAVF. We used digital subtraction angiography and reconstructed cone-beam computed tomography in 3D rotational angiography to obtain detailed anatomic information about the remnant PHS and additionally scrutinised and discussed its features.

Endovascular Treatment of an Intracranial Dural Arteriovenous Fistula with Spinal Venous Drainage

1998 ◽  
Vol 4 (3) ◽  
pp. 241-246 ◽  
Author(s):  
R. Cruz ◽  
A. Stocker ◽  
J. Xavier ◽  
J. Almeida-Pinto
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Clinical Presentation ◽  
Venous Drainage ◽  
Hyperintense Signal ◽  
Type V ◽  
Progressive Paraparesis ◽  
T2 Weighted Images

A case of type V intracranial dural arteriovenous fistula (DAVF) is reported because of its unusual rapidly progressive paraparesis. Despite this clinical presentation, the diagnosis of DAVF was made and precocious endovascular treatment was instituted. Angiographic normalization was obtained after embolisation and the patient significantly improved within the first weeks, although at the six month control MRI there still was a hyperintense signal of the cord in T2 weighted images, but less extensive than originally.

scholarly journals Transarterial Onyx embolization of jugular foramen dural arteriovenous fistula with spinal venous drainage manifesting as myelopathy—a case report and review of the literature

2016 ◽  
Vol 22 (5) ◽  
pp. 579-583 ◽  
Author(s):  
Hengwei Jin ◽  
Xianli Lv ◽  
Youxiang Li
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Brain Mri ◽  
Venous Drainage ◽  
Jugular Foramen ◽  
Endovascular Embolization ◽  
High Signal ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Progressive Weakness

We report a rare case of jugular foramen dural arteriovenous fistula (DAVF) with spinal venous drainage. A 48-year-old woman suffered from progressive weakness of lower extremities and incontinence of urine and feces for 14 days. Magnetic resonance imaging (MRI) revealed a tortuous posterior medullary vein at C2–T2 and ischemic signal at C2–C4 of the spinal cord. Brain MRI revealed an abnormal high signal near the left jugular foramen. Digital subtraction angiography of the spinal vascular was negative, while brain angiography showed a left jugular foramen DAVF with spinal perimedullary venous drainage. The patient recovered completely soon after endovascular embolization with Onyx-18. Diagnosis of a DAVF presenting with myelopathy is challenging. Early diagnosis and treatment are essential for a favorable outcome.

Usefulness of three-dimensional digital subtraction angiography in endovascular treatment of a spinal dural arteriovenous fistula

2008 ◽  
Vol 8 (5) ◽  
pp. 462-467 ◽  
Author(s):  
Noriaki Matsubara ◽  
Shigeru Miyachi ◽  
Takashi Izumi ◽  
Tomotaka Ohshima ◽  
Arihito Tsurumi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Bone Structure ◽  
Maximum Intensity Projection ◽  
Endovascular Embolization ◽  
Intercostal Artery ◽  
Digital Subtraction ◽  
Spinal Dural Arteriovenous Fistula ◽  
The Relationship

✓The use of 3D digital subtraction (DS) angiography provides a better understanding of spinal vascular lesion architecture. The authors report on 2 cases involving a spinal dural arteriovenous fistula (DAVF) and demonstrate the usefulness of 3D DS angiography for endovascular treatment of these spinal DAVFs. In both cases, middle-aged male patients suffered from bilateral leg hypesthesia, gait disturbance, and urinary dysfunction several months before treatment. Spinal angiography revealed DAVFs that were fed by a radicular artery branching from the intercostal artery and draining veins proceeding superiorly along the perimedullary veins. Endovascular embolization was performed in both cases. Selective 3D DS angiography of the intercostal artery clearly demonstrated the tortuous course of the feeder and the relationship among the feeding artery, fistula point, and draining veins in each case. This information was very useful in selecting a working angle for manipulating the microcatheter and for glue injection. In addition, the maximum intensity projection image from rotational DS angiography data clearly showed the fistula point at the dural sleeve and feeder entering the spinal canal via the intervertebral foramen and the relationship with the bone structure. Successful obliteration of the fistulae was achieved in both cases. Selective spinal 3D DS angiography was very useful in understanding the complex spinal vascular architecture and in choosing the best working angle and therapeutic strategy for endovascular treatment of spinal DAVFs.

scholarly journals Endovascular treatment of a tentorial dural arteriovenous fistula

2014 ◽  
Vol 37 (v1supplement) ◽  
pp. 1 ◽  
Author(s):  
Omar Choudhri ◽  
Michael P. Marks
Keyword(s):  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Cerebral Artery ◽  
Dural Arteriovenous Fistula ◽  
Posterior Cerebral Artery ◽  
Interesting Case ◽  
Venous Hypertension ◽  
Vein Of Galen ◽  
Arteriovenous Fistulae ◽  
Tentorium Cerebelli

Tentorial dural arteriovenous fistulae are rare intracranial fistulae, in which the fistula pocket is present within the leaves of tentorium cerebelli. These tentorial fistulae can be rarely present near the galenic complex, where they can engorge the deep venous system and cause symptoms of venous hypertension. We present an interesting case of endovascular treatment of a galenic tentorial dural arteriovenous fistula in a patient with headaches and imbalance. The fistula was accessed through the artery of Davidoff and Schecter from the posterior cerebral artery supplying the fistula. The fistula was completely embolized using Onyx and with preservation of vein of Galen.The video can be found here: http://youtu.be/igX2X5tfvrg.

scholarly journals Bilateral Cervical Spinal Dural Arteriovenous Fistulas with Intracranial Venous Drainage Mimicking a Foramen Magnum Dural Arteriovenous Fistula

2013 ◽  
Vol 19 (4) ◽  
pp. 483-488 ◽  
Author(s):  
Steven W. Hetts ◽  
Joey D. English ◽  
Shirley I. Stiver ◽  
Vineeta Singh ◽  
Erin J. Yee ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Foramen Magnum ◽  
Venous Hypertension ◽  
Complex Case ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Diagnostic Angiography ◽  
Spinal Dural Arteriovenous Fistulas

We describe a unique case of bilateral cervical spinal dural arteriovenous fistulas mimicking an intracranial dural arteriovenous fistula near the foramen magnum. We review its detection via MRI and digital subtraction angiography and subsequent management through surgical intervention. Pitfalls in diagnostic angiography are discussed with reference to accurate location of the fistula site. The venous anastomotic connections of the posterior midline spinal vein to the medial posterior medullary vein, posterior fossa bridging veins, and dural venous sinuses of the skull base are discussed with reference to problem-solving in this complex case. The mechanism of myelopathy through venous hypertension produced by spinal dural fistulas is also emphasized.

scholarly journals Dural arteriovenous fistula in the sphenoid bone lesser wing region: Endovascular adjuvant techniques of treatment and literature review

2018 ◽  
Vol 24 (5) ◽  
pp. 559-566 ◽  
Author(s):  
Dmitriy V Kandyba ◽  
Konstantin N Babichev ◽  
Artem V Stanishevskiy ◽  
Arevik A Abramyan ◽  
Dmytriy V Svistov
Keyword(s):  
Literature Review ◽  
Endovascular Treatment ◽  
Arteriovenous Fistula ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Sphenoid Bone ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
The Given ◽  
Balloon Protection

This article describes the successful endovascular treatment of a dural arteriovenous fistula of a rare localization (the area of sphenoid bone lesser region). We examine one report of an unusually located dural arteriovenous fistula successfully treated with Onyx (ev3, Irvine, USA) using a combination of endovascular adjuvant techniques: pressure cooker and remodeling balloon protection of cerebral artery. The article includes previously published observations of such fistulas and discusses anatomic features and venous drainage of dural arteriovenous fistulas in the given location.

Sign in / Sign up

Export Citation Format

Share Document