scholarly journals Cavernous Sinus Dural Arteriovenous Fistula Unresponsive to Transvenous Embolization Via the Inferior Petrosal Sinus

2005 ◽  
Vol 33 (3) ◽  
pp. 180-186
Author(s):  
Masato OHKI ◽  
Takamasa KAYAMA ◽  
Yasuaki KOKUBO ◽  
Shinjiro SAITO ◽  
Rei KONDO ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Inferior Petrosal Sinus ◽  
Transvenous Embolization

scholarly journals Cavernous sinus dural arteriovenous fistula treated by facial vein direct puncture: Case report and review of the literature

2017 ◽  
Vol 23 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Atsushi Matsumoto ◽  
Masanobu Okauchi ◽  
Atsushi Shindo ◽  
Masahiko Kawanishi ◽  
Takashi Tamiya
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Inferior Petrosal Sinus ◽  
Digital Subtraction ◽  
Transvenous Embolization ◽  
Review Of The Literature ◽  
Direct Puncture ◽  
Facial Vein

Introduction In case of cavernous sinus dural arteriovenous fistula (CSDAVF), transvenous embolization (TVE) of the cavernous sinus (CS) via the inferior petrosal sinus (IPS) is generally performed. However, various approach routes have been reported when the accessibility of the IPS is challenging. We herein report a case of CSDAVF treated by TVE with direct puncture of the facial vein. Case report A 70-year-old woman who suffered from tinnitus, chemosis, diplopia and bruit was referred to our hospital. Digital subtraction angiography (DSA) demonstrated CSDAVF. We initially attempted to perform TVE via the IPS route; however, we could not guide a catheter to the CS because of an anatomical difficulty. Then, we performed percutaneous direct puncture of the dilated facial vein, and successfully treated the patient. Conclusion When navigating microcatheter to the CS is difficult because of an anatomical difficulty of the IPS, direct puncture of the facial vein is a feasible route.

scholarly journals Resolution of Clinical Symptoms after Reopening of an Occluded Inferior Petrosal Sinus in a Patient with a Cavernous Sinus Dural Arteriovenous Fistula

2013 ◽  
Vol 19 (1) ◽  
pp. 78-82
Author(s):  
A. Kojima ◽  
S. Onozuka ◽  
Y. Kinoshita
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Vascular Complications ◽  
Inferior Petrosal Sinus ◽  
Transvenous Embolization ◽  
Shunt Flow ◽  
Flow Through ◽  
One Year

We describe a rare case with a cavernous sinus (CS) dural arteriovenous fistula (DAVF) in which the clinical symptoms disappeared after the patient underwent reopening of an occluded inferior petrosal sinus (IPS). A 66-year-old woman presented with increased intraocular pressure, chemosis, and proptosis on the left side. Angiography demonstrated a left CS DAVF supplied by the dural branches of bilateral internal carotid arteries. The shunt flow was directed to the superior and inferior ophthalmic veins, while the bilateral IPSs were not opacified. Accordingly, a transvenous embolization of the fistula was attempted. Although the microcatheter was navigated to the cavernous sinus through the occluded left IPS, obliteration of the fistula was unsuccessful because of the failure of superselective catheterization at the fistulous point. However, the final image demonstrated the development of an antegrade shunt flow through the left IPS to the internal jugular vein and disappearance of the retrograde reflux to the superior and inferior ophthalmic veins. The patient's clinical symptoms immediately resolved after the operation, and the symptoms have not recurred during a one-year follow-up period. Inappropriate transvenous embolization of CS DAVFs can result in vascular complications arising from the unintentional redistribution of shunt flow. The present case illustrates that the disappearance of retrograde shunt flow to the ophthalmic veins after reopening of the occluded IPS may be sufficient if a superselective approach fails or is anticipated to result only in an incomplete embolization of the fistulous point.

scholarly journals Transvenous Embolization for Dural Arteriovenous Shunt of the Cavernous Sinus

2007 ◽  
Vol 13 (4) ◽  
pp. 353-358 ◽  
Author(s):  
S. Kato ◽  
H. Ishihara ◽  
H. Nakayama ◽  
M. Fujii ◽  
H. Fujisawa ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Cranial Nerve ◽  
Dural Arteriovenous Fistula ◽  
Clinical Symptoms ◽  
Transarterial Embolization ◽  
Arteriovenous Shunt ◽  
Complete Disappearance ◽  
Transvenous Embolization ◽  
Arteriovenous Shunts

We describe the treatment and follow-up clinical symptoms and angiographic results in patients with dural arteriovenous fistula of the cavernous sinus treated by transvenous embolization (TVE). We have treated eight cases of dural arteriovenous fistula of the cavernous sinus by multi-staged TVE in two cases and TVE with sinus packing in six and three of six cases were treated with a combination of transarterial embolization. Multi-staged TVE was performed by occlusion from dangerous drainage veins to the cavernous sinus on several occasions. Angiographical results showed disappearance or reduction of the arteriovenous shunt in all cases. Six patients presented with ophthalmic symptoms and two had tinnitus. Six cases had complete disappearance of clinical symptoms after treatment. There was a deterioration of ocular movement in one patient treated by TVE with sinus packing. Multi-staged TVE was performed to reduce the coil volume for the packing of the cavernous sinus in two cases without cranial nerve palsy. Embolization, especially multi-staged TVE, was considered a good treatment to occlude arteriovenous shunts at the cavernous sinus without cranial nerve complications.

Resolution of Trigeminal Neuralgia After Transvenous Embolization of a Cavernous Sinus Dural Arteriovenous Fistula

2017 ◽  
Vol 98 ◽  
pp. 880.e5-880.e8 ◽  
Author(s):  
Kenji Fukutome ◽  
Ichiro Nakagawa ◽  
Hun Soo Park ◽  
Takeshi Wada ◽  
Yasushi Motoyama ◽  
...  
Keyword(s):  
Trigeminal Neuralgia ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Transvenous Embolization

scholarly journals Cavernous sinus dural arteriovenous fistula accessed through a straightened superficial temporal vein

2021 ◽  
Vol 12 ◽  
pp. 634
Author(s):  
Teishiki Shibata ◽  
Yusuke Nishikawa ◽  
Takumi Kitamura ◽  
Mitsuhito Mase
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Chronic Total Occlusion ◽  
Nerve Palsy ◽  
Dural Arteriovenous Fistula ◽  
Abducens Nerve ◽  
Transvenous Embolization ◽  
Access Route ◽  
Treatment Procedure ◽  
Total Occlusion

Background: Transvenous embolization through the inferior petrosal sinus (IPS) is the most common treatment procedure for cavernous sinus dural arteriovenous fistula (CSDAVF). When the IPS is inaccessible or the CSDAVF cannot be treated with transvenous embolization through the IPS, the superficial temporal vein (STV) is used as an alternative access route. However, the approach through the STV is often challenging because of its tortuous and abruptly angulated course. We report a case of recurrent CSDAVF which was successfully treated using a chronic total occlusion (CTO)-dedicated guidewire and by straightening the STV. Case Description: A 63-year-old woman was diagnosed with CSDAVF on examination for oculomotor and abducens nerve palsy. She was initially treated with transvenous embolization through the IPS. However, CSDAVF recurred, and transvenous embolization was performed through the STV. A microcatheter could not be navigated because of the highly meandering access route through the STV. By inserting a CTO-dedicated guidewire into the microcatheter, the STV was straightened and the microcatheter could be navigated into a shunted pouch of the CS. Finally, complete occlusion of the CSDAVF was achieved. Conclusion: If an access route is highly meandering, the approach can be facilitated by straightening the access route with a CTO-dedicated guidewire.

scholarly journals Spontaneous closure of a cavernous sinus dural arteriovenous fistula with spinal perimedullary drainage (Cognard V) during attempted transvenous embolization

2019 ◽  
Vol 14 (4) ◽  
pp. 1268
Author(s):  
Prasert Iampreechakul ◽  
Korrapakc Wangtanaphat ◽  
Punjama Lertbutsayanukul ◽  
Yodkhwan Wattanasen ◽  
Somkiet Siriwimonmas
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Spontaneous Closure ◽  
Transvenous Embolization

scholarly journals Transvenous Embolization of Dural Arteriovenous Fistula of the Cavernous Sinus

2004 ◽  
Vol 10 (1_suppl) ◽  
pp. 85-92 ◽  
Author(s):  
S. Takahashi ◽  
I. Sakuma ◽  
N. Tomura ◽  
J. Watarai ◽  
K. Mizoi
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Gadopentetate Dimeglumine ◽  
Venous Access ◽  
Transvenous Embolization ◽  
Mr Images ◽  
Transfemoral Approach ◽  
Posterior Portion ◽  
Contrast Enhanced

We reviewed magnetic resonance (MR) images and digital subtraction angiograms (DSA) from eight patients with dural arteriovenous fistula of the cavernous sinus (DAVFCS) to clarify the fistulous points and to evaluate the venous access routes into the cavernous sinus for transvenous embolization (TVE). Multiplanar reconstruction of the MR images was achieved using three-dimensional fast spoiled gradient-recalled acquisition in the steady state (3-D fast SPGR) after the intravenous administration of gadopentetate dimeglumine (Gd-DTPA). TVE was performed using microcoils via the inferior petrosal sinus (IPS) using the transfemoral approach in five patients, via the facial vein and superior ophthalmic vein (SOV) using the transfemoral approach in 1 patient, and by SOV puncture in two patients. Most fistulas were detected in the posterior portion of the cavernous sinus or in the posterior intercavernous sinus in all of the patients. Fistulas identified as hyperintense dots or lines on contrast-enhanced 3-D fast SPGR images and were replaced with the microcoils. Target embolization of the fistulas was feasible in three patients treated via the SOV and in one patient treated via the IPS. Contrast-enhanced 3-D fast SPGR can help to identify the fistulous points of DAVFCS. Precise identification of fistulous points and selection of the adequate access route are mandatory for efficient TVE of DAVFCS.

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