A Case of Cavernous Sinus Dural Arteriovenous Fistula Treated by Transfacial Vein Placement of a Distal Access Catheter in the Cavernous Sinus

Chihara, H.; Sadamasa, Nobutake; Yang, Keming; Saka, Makoto; Ando, Mitsushige; Takita, Wataru; Tokunaga, Keisuke; Kamata, Takahiko; Nagata, Izumi

doi:10.5797/jnet.tn.2016-0127

Cited by 3 publications

(6 citation statements)

References 17 publications

(17 reference statements)

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“…Furthermore, another study adopted a TACTICS as a DAC for a transvenous approach in the treatment of cavernous sinus dural arteriovenous fistulae, and reported that TACTICS guiding to the cavernous sinus via facial-vein-or superiorophthalmic-vein-mediated approaches improved microcatheter/-guidewire operability, suggesting its usefulness. 5) The TACTICS may be available for embolization of feeding we guide microcatheter with a closed-cell-type neck bridge stent again to an area distal to an aneurysm, this can be achieved by guiding a TACTICS to the distal area, although there was no such case in our series.…”

Section: Discussionmentioning

confidence: 84%

Usefulness of Adjunctive Technique with a TACTICS Catheter for Coil Embolization of Cerebral Aneurysms

Takahara

Fukuda

Kawano

et al. 2021

JNET

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We report the usefulness of the adjunctive technique using a 3.4-Fr TACTICS catheter, which is a distal access catheter (DAC) for coil embolization. Methods: Patients who underwent coil embolization with an adjunctive technique using a TACTICS catheter between October 2018 and May 2019 were retrospectively analyzed. Results: In all, 64 aneurysms in 51 patients were treated. Among them, 18 aneurysms in 15 patients (4 ruptured aneurysms and 14 unruptured aneurysms) required an adjunctive technique using a TACTICS catheter. The methods of embolization were the double catheter technique (DCT) for five aneurysms, stent-assisted coiling (SAT) for seven, DCT + SAC for one, and balloon-assisted technique (BAT) for five aneurysms. Aneurysms were located in the anterior communicating artery (Acom A) in three cases, distal anterior cerebral artery (dACA) in one, middle cerebral artery (MCA) in five, internal carotid artery (ICA) in six, basilar artery (BA) in one, and vertebral artery (VA) in two cases. It was easy to access distal intracranial vessels using the TACTICS catheter. In all cases, guiding of the microcatheter, coiling, and stent placement were improved. There were no complications associated with using the TACTICS catheter. Conclusion: Compared with conventional DACs, distal intracranial vessels were more easily accessed using the TACTICS catheter. A TACTICS catheter is useful because DCT and SAC require sufficient operability of the microcatheter. Keywords▶ TACTICS, adjunctive technique, coil embolization This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Section: Discussionmentioning

confidence: 84%

Usefulness of Adjunctive Technique with a TACTICS Catheter for Coil Embolization of Cerebral Aneurysms

Takahara

Fukuda

Kawano

et al. 2021

JNET

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“…To solve this problem, there are methods to manually unbend the veins or to guide using a triple coaxial system. [ 4 , 21 ] In addition, a method, wherein a microcatheter is navigated by making a microwire loop and using it as an anchor, has been reported. [ 5 ] In this case, both the STV and the SOV were looped, and the access route was tortuous and abruptly angulated.…”

Section: Discussionmentioning

confidence: 99%

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

Shibata

Nishikawa

Kitamura³

et al. 2021

Surgical Neurology International

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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.

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“…Although it is often possible to perform TVE for CS-DAVFs via occluded IPSs, 7,8) Biondi et al 4) reported that it was difficult to navigate through thrombosed SOVs. As the trans-IPS approach is a short and straight access route to the CS, while the FV is a tortuous, long pathway containing various structures, 3,5,8,9) it might be difficult to catheterize thrombosed FVs, even using the triple coaxial method, due to the lack of supporting force. In cases in which the route of the anterior outflow tract is confirmed on preoperative CTA or US and trans-FV TVE is planned, if the anterior outflow tract is found to be thrombosed on intraoperative imaging, a change in the access route should be considered.…”

Section: Discussionmentioning

confidence: 99%

“…occluded IPS is not feasible, the SOV is often selected as an alternative access route to the CS. 4,5,7,10) The SOV has been recommended as an access route for reaching the anterior compartment of the CS, especially in cases involving occluded IPSs. 17) However, the absence of acute thrombosis of the SOV should be confirmed after catheter navigation through the FV, angular vein, and SOV.…”

Section: Discussionmentioning

confidence: 99%

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Access-route Visualization Using Ultrasonography and CT Angiography to Predict the Feasibility of Transvenous Embolization via the Facial Vein for Cavernous Sinus Dural Arteriovenous Fistulas

Oshita

Sakamoto

Okazaki

et al. 2020

JNET

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Transvenous embolization (TVE) is an effective treatment for cavernous sinus dural arteriovenous fistulas (CS-DAVFs). The facial vein (FV) can be used as an access route for TVE when a trans-inferior petrosal sinus (IPS) approach is difficult. We evaluated the usefulness of combining ultrasonography (US) with computed tomography angiography (CTA) for confirming that the FV is a suitable access route for treating CS-DAVFs.Methods: Trans-FV TVE was planned for five CS-DAVF patients in whom the shunt point was located in the posterior compartment of the CS and anterior venous drainage predominantly occurred via the superior ophthalmic vein (SOV).The anterior drainage route was examined with CTA and US. We reviewed the relationships between preoperative CTA/ US findings and the accessibility of CS-DAVFs via the FV. Results:The periorbital and perimandibular drainage pathways were clearly more visible on US than on CTA, and the cervical and thoracic drainage pathways were more visible on CTA than on digital subtraction angiography (DSA). CS-DAVFs were accessible via the FV when (1) the entire drainage pathway could be confirmed on CTA and US, (2) the periorbital and perimandibular pathways were unclear on CTA, but could be confirmed on US, or (3) the FV pathway drained into the internal jugular vein (IJV) or external jugular vein (EJV). On the other hand, TVE was challenging to perform via the FV when (1) the periorbital pathway was unclear on CTA and US, (2) the FV pathway drained into the brachiocephalic vein, or (3) the SOV thrombosed intraoperatively. In all five patients, TVE for CS-DAVFs performed via the FV or IPS was successful. Conclusion:CTA and US are useful for confirming the anterior access route for trans-FV TVE for CS-DAVFs and predicting the feasibility of such treatment. Our findings suggest that CS-DAVFs can be accessed via the FV if the periorbital drainage pathway can be confirmed on US, even if the pathway is unclear on CTA. Keywords▶ cavernous sinus dural arteriovenous fistula, facial vein, computed tomography angiography, ultrasonography, access route This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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A Case of Cavernous Sinus Dural Arteriovenous Fistula Treated by Transfacial Vein Placement of a Distal Access Catheter in the Cavernous Sinus

Cited by 3 publications

References 17 publications

Usefulness of Adjunctive Technique with a TACTICS Catheter for Coil Embolization of Cerebral Aneurysms

Usefulness of Adjunctive Technique with a TACTICS Catheter for Coil Embolization of Cerebral Aneurysms

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

Access-route Visualization Using Ultrasonography and CT Angiography to Predict the Feasibility of Transvenous Embolization via the Facial Vein for Cavernous Sinus Dural Arteriovenous Fistulas

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