Combining endovascular and neurosurgical treatments of high-risk dural arteriovenous fistulas in the lateral sinus and the confluence of the sinuses

Goto, Katsuya; Sidipratomo, Prijo; Ogata, Noboru; Inoue, Toru; Matsuno, Haruo

doi:10.3171/jns.1999.90.2.0289

Cited by 87 publications

(30 citation statements)

References 32 publications

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“…5 Various modalities are currently available to treat DCCF, such as endovascular procedures with transvenous, transarterial, or transarterial-transfistulous embolization, [6][7][8] surgery to obtain access to the fistula for embolization on either the venous or arterial side or to excise the fistula, 9 gamma knife surgery, 10 or a combination of the 3. 11 In selected cases, the lesions can also be treated conservatively. 12 We retrospectively analyzed 44 consecutive cases of DCCF managed in our institution and related institutions, by using primarily the transvenous route with an emphasis on feasibility, durability, and complications encountered with the approaches used, through clinical and angiographic follow-up.…”

mentioning

confidence: 99%

Transvenous Embolization of Dural Carotid Cavernous Fistulas: A Series of 44 Consecutive Patients

Yoshida¹,

Melake²,

Oishi³

et al. 2009

AJNR Am J Neuroradiol

115

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mentioning

confidence: 99%

Transvenous Embolization of Dural Carotid Cavernous Fistulas: A Series of 44 Consecutive Patients

Yoshida¹,

Melake²,

Oishi³

et al. 2009

AJNR Am J Neuroradiol

115

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“…Many tentorial DAVFs drain directly into subarachnoid veins, making transvenous access impossible. 3,4,7,8,12 The Onyx Liquid Embolic System (Covidien) was approved by the FDA in 2005 for the treatment of intracranial arteriovenous malformations but has been used off label for the treatment of DAVFs. 1,11,14 The availability of Onyx has introduced a new endovascular option for tentorial DAVFs otherwise considered better suited for surgical therapy.…”

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confidence: 99%

Curative Onyx embolization of tentorial dural arteriovenous fistulas

Puffer

Daniels

Kallmes³

et al. 2012

FOC

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Object The authors conducted a study to review their experience with tentorial dural arteriovenous fistulas (DAVFs) treated with transarterial endovascular embolization in which Onyx was used. Methods The authors reviewed prospectively collected data in 9 patients with tentorial DAVFs treated with Onyx embolization between 2008 and 2011. Information reviewed included clinical presentation, angiographic features, treatment, and clinical and radiologically documented outcome. Clinical follow-up was available in every patient. Radiological follow-up studies were available in 8 of 9 patients (mean follow-up 4.6 months). Results Six of 9 patients had complete angiographic obliteration (in 5 this was confirmed by a follow-up angiogram obtained 3–6 months later), and 2 patients had near-complete obliteration (faint filling of the venous drainage in the late venous phase). One patient had partial obliteration and required surgical disconnection. In all patients with complete obliteration, transarterial embolization was performed through the posterior branch of the middle meningeal artery. There were no procedural complications, and no morbidity or mortality resulted from Onyx embolization. Conclusions Transarterial Onyx embolization is a valid, effective, and safe alternative to surgical disconnection in many patients with tentorial DAVFs. The presence of an adequate posterior branch of the middle meningeal artery is critical to achieve a microcatheter position distal enough to increase the likelihood of complete obliteration.

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“…21,22 Among them, TVE has been widely accepted as an effective treatment. [5][6][7][8][9][10]23 However, seven cases demonstrating a new DAVF following endovascular treatments have been reported (Table).…”

Section: Discussionmentioning

confidence: 99%

Recurrence of the cavernous sinus dural arteriovenous fistula at adjacent sinuses following repeated transvenous embolizations: case report and literature review

et al. 2008

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We present a unique case of a cavernous sinus (CS) dural arteriovenous fistula (DAVF), which recurred at adjacent sinuses following repeated transvenous embolizations (TVEs).A 68-year-old woman presented progressive left conjunctival chemosis and diplopia.Cerebral angiography revealed a left CS DAVF, which was completely obliterated by TVE via the left inferior petrosal sinus (IPS). Two years later, the DAVF recurred in the left IPS, and in the left sigmoid sinus (SS) three years after the initial treatment in spite of second TVE.Moreover, the left SS and the left internal jugular vein, which had been previously stenotic, have been occluded. The third TVE resulted in the complete obliteration of the SS DAVF.CS DAVFs may recur at adjacent sinuses even after complete obliteration by TVE. Careful follow-up is necessary to check for the recurrence of DAVFs especially in cases with venous flow changes, such as sinus occlusion, following endovascular treatments.

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Combining endovascular and neurosurgical treatments of high-risk dural arteriovenous fistulas in the lateral sinus and the confluence of the sinuses

Abstract: The authors believe that by close collaboration between endovascular therapists and vascular neurosurgeons, high-risk DAVFs in the lateral sinus and the confluence of sinuses can be successfully managed without treatment-related morbidity and mortality.

Cited by 87 publications

References 32 publications

Transvenous Embolization of Dural Carotid Cavernous Fistulas: A Series of 44 Consecutive Patients

Transvenous Embolization of Dural Carotid Cavernous Fistulas: A Series of 44 Consecutive Patients

Curative Onyx embolization of tentorial dural arteriovenous fistulas

Recurrence of the cavernous sinus dural arteriovenous fistula at adjacent sinuses following repeated transvenous embolizations: case report and literature review

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