scholarly journals Novel Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula

2021 ◽  
Author(s):  
Rasmiranjan Padhi ◽  
Sathish Kandasamy ◽  
Balasenthil Kumaran ◽  
Naci Kocer ◽  
Harshith Karmadhari
Keyword(s):  
Venous Drainage ◽  
Superior Ophthalmic Vein ◽  
Direct Puncture ◽  
Av Fistula ◽  
Third Nerve Palsy ◽  
Hypoglossal Canal ◽  
Arteriovenous Fistulas ◽  
Drainage Patterns ◽  
Complete Obliteration ◽  
Catheter Tip

Dural arteriovenous fistulas (DAVFs) are acquired pathological arteriovenous connections involving vessels that usually supply the meninges. A DAVF in the region of the hypoglossal canal is a rare form of fistula that involves the anterior condylar confluence or anterior condylar vein. We report a case of hypoglossal canal DAVF that was successfully embolized transvenously through a superior ophthalmic vein (SOV) approach. After failed attempts through jugular access, our patient was treated by a unique percutaneous direct puncture approach through the SOV, achieving complete obliteration of the fistula. A step-by-step description of the endovascular technique was described. The clinical course was uneventful without any new neurologic deficit. The eye symptoms and third nerve palsy had completely resolved at the 3-month follow-up visit. Hypoglossal canal DAVFs are rare and may exhibit complex venous drainage patterns. Knowledge of the complex venous anatomy is essential for planning an alternative transvenous route if the standard approach is not feasible. Xper CT (Philips Healthcare, Best, The Netherlands) is an excellent tool for identifying the exact site of the fistula as well as for confirming a safe position of the catheter tip for successful occlusion of this complex dural AV fistula.

A variant of arteriovenous fistulas within the wall of dural sinuses. Results of combined surgical and endovascular therapy

1991 ◽  
Vol 74 (2) ◽  
pp. 199-204 ◽  
Author(s):  
Stanley L. Barnwell ◽  
Van V. Halbach ◽  
Christopher F. Dowd ◽  
Randall T. Higashida ◽  
Grant B. Hieshima ◽  
...  
Keyword(s):  
Venous Drainage ◽  
Venous Hypertension ◽  
Neurological Dysfunction ◽  
Dural Sinus ◽  
Unique Type ◽  
Content Type ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Av Fistulas ◽  
Cortical Venous Drainage

✓ Dural arteriovenous (AV) fistulas are thought to be acquired lesions that form in an area of thrombosis within a sinus. If the sinus remains completely thrombosed, venous drainage from these lesions occurs through cortical veins, or, if the sinus is open, venous drainage is usually into the involved sinus. Among 105 patients with dural A V fistulas evaluated over the the past 5 years, seven had a unique type of dural AV fistula in the superior sagittal, transverse, or straight sinus in which only cortical venous drainage occurred despite a patent involved sinus; the fistula was located within the wall of a patent dural sinus, but outflow was not into the involved sinus. This variant of dural AV fistulas puts the patient at serious risk for hemorrhage or neurological dysfunction caused by venous hypertension. Three patients presented with hemorrhage, one with progressive neurological dysfunction, one with seizures, and two with bruit and headaches. A combination of surgical and endovascular techniques was used to close the fistula while preserving flow through the sinus.

scholarly journals Pediatric Thoraco-Lumbar Paraspinal Arteriovenous Fistulas along the Segmental Nerve

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 158-162
Author(s):  
Y. Niimi ◽  
A. Berenstein ◽  
P.M. Fernandez ◽  
J.L. Brisman ◽  
J.K. Song
Keyword(s):  
Venous Drainage ◽  
Imaging Features ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Thoracic Level ◽  
Segmental Nerve ◽  
First Choice ◽  
Diagnostic Angiography ◽  
Choice Of Treatment ◽  
Detachable Coils

To characterize the clinical presentation, imaging features and endovascular treatment of paraspinal non-vertebral arteriovenous fistulas along the segmental nerve. Retrospective review was performed on the five patients identified in our database covering 1985 to 2003. All patients presented with an incidentally found continuous murmur over the upper paraspinal or parasternal regions before three years old. In four patients, the AV fistula was in the mid-thoracic level and at L3 in one. All AV fistulas were a high-flow single-hole fistula at the neural foramen with venous drainage into paraspinal and epidural veins without intradural reflux. All fistulas were endovascularly occluded in the same session as the diagnostic angiography. The fistula was occluded with detachable coils in one case and with N-butylcyanoacrylate (NBCA) with flow control in four cases. Complete occlusion of the fistula was obtained in all cases and all patients remained neurologically intact at the last follow up (average six years). Non-vertebral paraspinal arteriovenous fistula along the segmental nerve is a specific disease entity seen in children. Embolization is the first choice of treatment for this disease.

Dural arteriovenous fistulas presenting with brainstem dysfunction: diagnosis and surgical treatment

2012 ◽  
Vol 32 (5) ◽  
pp. E10 ◽  
Author(s):  
Charles Kulwin ◽  
Bradley N. Bohnstedt ◽  
John A. Scott ◽  
Aaron Cohen-Gadol
Keyword(s):  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Craniocervical Junction ◽  
Rare Entity ◽  
Arteriovenous Fistulas ◽  
Drainage Patterns ◽  
Clinical Presentations ◽  
Wide Range ◽  
Brainstem Dysfunction ◽  
Dural Arteriovenous Fistulas

A cerebral dural arteriovenous fistula (DAVF) is an acquired abnormal arterial-to-venous connection within the leaves of the intracranial dura with a wide range of clinical presentations and natural history. The Cognard classification correlates venous drainage patterns with neurological course, identifying 5 DAVF types with increasing rates of symptomatic presentation. A spinal DAVF occurs when a radicular artery makes a direct anomalous shunt with a radicular vein within the dural leaflets of the nerve root sleeve. A cervical DAVF is a rare entity, as most spinal DAVFs present as thoracolumbar lesions with myelopathy. In this paper the authors present 2 patients presenting initially with brainstem dysfunction rather than myelopathy secondary to craniocervical DAVF. The literature is then reviewed for similar rare aggressive DAVFs at the craniocervical junction presenting with brainstem symptomatology.

Dural Arteriovenous Fistulas with Venous Drainage Patterns Inducing Ocular Manifestations Mimicking a Carotid Cavernous Fistula: Report of 2 Cases

2019 ◽  
Vol 127 ◽  
pp. 216-219 ◽  
Author(s):  
Mohammad Ghorbani ◽  
Sina Asaadi ◽  
Christoph Wipplinger ◽  
Christoph J. Griessenauer ◽  
Fatemeh Zangi-Abadi ◽  
...  
Keyword(s):  
Venous Drainage ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Arteriovenous Fistulas ◽  
Ocular Manifestations ◽  
Drainage Patterns ◽  
Dural Arteriovenous Fistulas

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.

Pediatric Thoraco-lumbar Paraspinal Arteriovenous Fistulas along the Segmental Nerve

1995 ◽  
Vol 8 (6) ◽  
pp. 158-162
Author(s):  
Y. Niimi ◽  
A. Berenstein ◽  
P.M. Fernandez ◽  
J.L. Brisman ◽  
J.K. Song
Keyword(s):  
Venous Drainage ◽  
Imaging Features ◽  
Av Fistula ◽  
Arteriovenous Fistulas ◽  
Thoracic Level ◽  
Segmental Nerve ◽  
First Choice ◽  
Diagnostic Angiography ◽  
Choice Of Treatment ◽  
Detachable Coils

To characterize the clinical presentation, imaging features and endovascular treatment of paraspinal non-vertebral arteriovenous fistulas along the segmental nerve. Retrospective review was performed on the five patients identified in our database covering 1985 to 2003. All patients presented with an incidentally found continuous murmur over the upper paraspinal or parasternal regions before three years old. In four patients, the AV fistula was in the mid-thoracic level and at L3 in one. All AV fistulas were a high-flow single-hole fistula at the neural foramen with venous drainage into paraspinal and epidural veins without intradural reflux. All fistulas were endovascularly occluded in the same session as the diagnostic angiography. The fistula was occluded with detachable coils in one case and with N-butylcyanoacrylate (NBCA) with flow control in four cases. Complete occlusion of the fistula was obtained in all cases and all patients remained neurologically intact at the last follow up (average six years). Non-vertebral paraspinal arteriovenous fistula along the segmental nerve is a specific disease entity seen in children. Embolization is the first choice of treatment for this disease.

Cavernous Dural Arteriovenous Fistulas

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 86-87 ◽  
Author(s):  
S. Nemoto ◽  
Y. Mayanagi ◽  
T. Kirino
Keyword(s):  
Endovascular Treatment ◽  
Dural Arteriovenous Fistula ◽  
Venous Drainage ◽  
Common Finding ◽  
Inferior Petrosal Sinus ◽  
Superior Ophthalmic Vein ◽  
Transfemoral Approach ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas ◽  
Selection Of

In transvenous endovascular treatment of dural arteriovenous fistula (AVE), access to the affected sinus is determined by venous drainage. In cavernous dural AVF, the route to the cavernous sinus is through the inferior petrosal sinus (IPS) or the superior ophthalmic vein. Other venous routes are not practical. Occlusive change of the IPS is a common finding. The transfemoral approach is not always easy because of obliteration of the IPS. In selection of the approach for the transvenous treatment of the cavernous dural AVF, these occlusive changes should be considered.

scholarly journals Puncture of the Superficial Sylvian Vein for Embolisation of Cavernous Dural Arteriovenous Fistula

1999 ◽  
Vol 5 (2) ◽  
pp. 167-170 ◽  
Author(s):  
G. Benndorf ◽  
T.N. Lehmann ◽  
H.P. Molsen ◽  
W. Lanksch ◽  
R. Felix
Keyword(s):  
Cavernous Sinus ◽  
Venous Drainage ◽  
Direct Puncture ◽  
Arteriovenous Fistulas ◽  
Surgical Exposure ◽  
Dural Arteriovenous Fistulas ◽  
Femoral Route ◽  
Endovascular Approach ◽  
Catheter Navigation ◽  
Cortical Venous Drainage

Dural arteriovenous fistulas (DAVF's) of the cavernous sinus are curable by endovascular means in the vast majority of cases. Both transarterial and transvenous approaches by femoral route can be used for closure. In rare cases with unsuitable anatomy or angioarchitecture, an endovascular approach is proposed by open surgical exposure of a major venous outflow, e.g. the superior ophthalmic vein. We report on a case of unsuccessful attempts at transarterial and transvenous catheter navigation through traditional endovascular routes, where surgical exposure of the major cortical venous drainage was necessary. A direct puncture of the sylvian vein allowed placement of a microcatheter in the cavernous sinus and occlusion of the fistula by coils.

scholarly journals Stereotactic radiosurgery for intracranial dural arteriovenous fistulas: a systematic review

2015 ◽  
Vol 122 (2) ◽  
pp. 353-362 ◽  
Author(s):  
Ching-Jen Chen ◽  
Cheng-Chia Lee ◽  
Dale Ding ◽  
Robert M. Starke ◽  
Srinivas Chivukula ◽  
...  
Keyword(s):  
Stereotactic Radiosurgery ◽  
Venous Drainage ◽  
Classification Systems ◽  
Complication Rates ◽  
Obliteration Rate ◽  
Arteriovenous Fistulas ◽  
Significant Difference ◽  
Dural Arteriovenous Fistulas ◽  
Complete Obliteration ◽  
Cortical Venous Drainage

OBJECT The goal of this study was to evaluate the obliteration rate of intracranial dural arteriovenous fistulas (DAVFs) in patients treated with stereotactic radiosurgery (SRS), and to compare obliteration rates between cavernous sinus (CS) and noncavernous sinus (NCS) DAVFs, and between DAVFs with and without cortical venous drainage (CVD). METHODS A systematic literature review was performed using PubMed. The CS DAVFs and the NCS DAVFs were categorized using the Barrow and Borden classification systems, respectively. The DAVFs were also categorized by location and by the presence of CVD. Statistical analyses of pooled data were conducted to assess complete obliteration rates in CS and NCS DAVFs, and in DAVFs with and without CVD. RESULTS Nineteen studies were included, comprising 729 patients harboring 743 DAVFs treated with SRS. The mean obliteration rate was 63% (95% CI 52.4%–73.6%). Complete obliteration for CS and NCS DAVFs was achieved in 73% and 58% of patients, respectively. No significant difference in obliteration rates between CS and NCS DAVFs was found (OR 1.72, 95% CI 0.66–4.46; p = 0.27). Complete obliteration in DAVFs with and without CVD was observed in 56% and 75% of patients, respectively. A significantly higher obliteration rate was observed in DAVFs without CVD compared with DAVFs with CVD (OR 2.37, 95% CI 1.07–5.28; p = 0.03). CONCLUSIONS Treatment with SRS offers favorable rates of DAVF obliteration with low complication rates. Patients harboring DAVFs that are refractory or not amenable to endovascular or surgical therapy may be safely and effectively treated using SRS.

Ocular symptoms associated with a dural arteriovenous fistula involving the hypoglossal canal: selective transvenous coil embolization

2001 ◽  
Vol 94 (4) ◽  
pp. 630-632 ◽  
Author(s):  
Hiro Kiyosue ◽  
Shuichi Tanoue ◽  
Mika Okahara ◽  
Miyuki Mori ◽  
Hiromu Mori
Keyword(s):  
Coil Embolization ◽  
Venous Drainage ◽  
Resonance Imaging ◽  
Content Type ◽  
Hypoglossal Canal ◽  
Arteriovenous Fistulas ◽  
Ocular Symptoms ◽  
Dural Arteriovenous Fistulas ◽  
Careful Assessment

✓ The hypoglossal canals are an unusual location for dural arteriovenous fistulas (AVFs) to appear. One previous report of dural AVFs involving the hypoglossal canal has been published. In the present paper, the authors describe a dural AVF within the hypoglossal canal, which presented with ocular symptoms and was successfully treated by selective transvenous embolization. Magnetic resonance imaging and contralateral carotid arteriography were useful for determination of the exact location of the fistulous pouch, which was later packed with coils. Selective transvenous coil embolization with careful assessment of the location and pattern of the venous drainage of the dural AVF is a safe and effective treatment.

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