Transarterial Embolization of Dural Arteriovenous Fistula in Superior Sagittal Sinus Under Bilateral External Carotid Artery Flow Control: Technical Note

Kotsugi, Masashi; Nakagawa, Ichiro; Takamura, Yoshiaki; Wada, Takeshi; Kichikawa, Kimihiko; Nakase, Hiroyuki

doi:10.1016/j.wneu.2019.07.012

Cited by 6 publications

(7 citation statements)

References 17 publications

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“…A total of 31 cases of vSSS DAVF were reported in 20 publications. 2,[5][6][7][8][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] We analyzed general demographic, clinical, radiological, angiographic, and treatment features of all these cases along with clinical outcome (►Table 1 and ►Table 2).…”

Section: Resultsmentioning

confidence: 99%

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Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

Chavan

Sethi

Sahu

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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Dural arteriovenous fistulas (DAVFs) located within superior sagittal sinus (SSS) wall with direct cortical venous drainage are rare. They are also known as variant DAVF (vDAVF) and form a special subgroup of DAVFs. Their chance of presenting with aggressive features is high compared with transverse sigmoid sinus fistula. They drain directly into cortical veins (Borden type 3, Cognard type III and IV). A systematic English literature review of SSS vDAVF was made. Systematic literature review revealed a total of 31 published cases. These were commonly seen in male population, (24 males, 77.41%, 24/31). Average age of patients was 54 years. A total of 24 patients (77.41%, 24/31) had aggressive clinical presentations with 13 patients (41.93%, 13/31) having intracranial hemorrhages (ICH). Two patients had rebleeding (15.38%, 2/13). Middle portion of SSS was commonly involved (15 cases, 75%). A total of 25 (96.15%, 25/26) cases had patent SSS. Most of the fistulas were idiopathic (65.38%, 17/26), with trauma being a frequent etiological factor (26.92%, 7/26). Venous ectasia was seen in 19 patients (59.37%, 19/32). Middle meningeal arterial (MMA) supply was seen in all patients (100%, 26/26), with bilateral MMA supply in 21 cases (80.76%), and unilateral in 5 cases (19.23%). Twenty patients (62.50%, 20/32) received only endovascular treatment (EVT), while four patients had EVT followed by surgery (12.5%, 4/32). Transarterial route via MMA was the preferred treatment option (79.16%). Complete obliteration of fistulas was noted in all cases (100%, 30/30). No immediate complication was noted after EVT. As much as 92.30% patients showed good recovery. Thus, SSS vDAVF forms a special subgroup of DAVF, with aggressive presentation, and warrants urgent treatment. EVT is effective treatment option and can produce complete obliteration.

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Section: Resultsmentioning

confidence: 99%

“…Balloon guide catheters have been used in bilateral external carotid arteries to control blood flow during embolization with NBCA. 24…”

Section: Embolic Agentsmentioning

confidence: 99%

Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

Chavan

Sethi

Sahu

et al. 2021

Journal of Clinical Interventional Radiology ISVIR

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“…Although previous studies have reported methods to control blood flow in the STA, these methods have been used mostly in transarterial embolization (TAE) of dural arteriovenous fistulas 6 , 7 and rarely in tumor embolization. Onishi et al 4 reported a method for controlling control blood flow in the STA by occluding the proximal portion of the STA with coils.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have reported on how to control blood flow from the STA. 4 , 6 , 7 Occlusion of the STA with an embolic material is undesirable, because it may adversely affect wound healing, considering the subsequent tumor removal procedure. 5 Furthermore, as compared with the MMA, the STA is very tortuous, and guiding microcatheters to the feeding vessels near the tumor is not easy.…”

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confidence: 99%

Manual superficial temporal artery compression using a circular plastic material for embolization of meningioma: illustrative case

Horio

Miki²,

Kawano

et al. 2023

Journal of Neurosurgery: Case Lessons

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BACKGROUND In meningiomas that occur in the high-convexity region, the superficial temporal artery (STA) frequently feeds the tumor, and when embolizing from the middle meningeal artery (MMA), the embolic material may not reach the tumor vessels because of the pressure gradient resulting from the STA blood flow, resulting in inadequate embolization. In this case, a circular plastic material was used to apply circumferential pressure around the parietal foramen to control blood flow to the tumor. OBSERVATIONS A 45-year-old male underwent head magnetic resonance imaging that revealed a 2.2-cm meningioma in the right high-convexity region. Preoperative embolization was performed. When N-butyl-2-cyanoacrylate was injected from the right MMA while using a circular plastic material to compress the skin around the parietal foramen through which the bilateral STAs (the tumor feeders) flow, it was able to fully penetrate the tumor vessel and occlude the other feeders in a retrograde manner. The patient underwent tumor removal after embolization uneventfully. LESSONS Manual compression of the STA using a circular plastic material is useful when the tumor is fed by the STA through the parietal foramen and is also applicable to transarterial embolization of dural arteriovenous fistulas fed by the STA or occipital artery.

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“…With regard to Onyx TAE, balloon-assisted techniques are anticipated to expand the application range of this liquid, non-adhesive agent. In general, these approaches include balloon devascularization of the collateral arterial branches, 22 , 23 , 40) proximal flow control of the injecting artery, 20 , 37 , 40) and protection of the functioning but compromised sinus. 14 , 35) The details of each technique have been described previously.…”

Section: Discussionmentioning

confidence: 99%

A Comprehensive Analysis of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus: A Systematic Review

Kurabe

Kumagai

Abe

2021

JNET

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To evaluate published papers concerning dural arteriovenous fistula involving the superior sagittal sinus (SSS dAVF) treated with endovascular intervention.Methods: A literature review was performed to identify studies reporting the clinical characteristics, vascular anatomy, endovascular techniques, embolic materials, angiographical result, and outcomes of SSS dAVF. Results:The analysis consisted of 40 case reports or series, comprising a total of 51 cases of SSS dAVF treated with endovascular intervention. Clinical symptoms included hemorrhage (29.4%), infarction (17.6%), and seizure (7.8%). The arterial supply included the middle meningeal artery (MMA) (100%), superficial temporal artery (STA) (62.7%), and occipital artery (OA) (49.0%). Bilateral MMAs supplied in 78.4% of the cases. A pial arterial supply was observed in 21.6% of the cases. Stenosis or occlusion of the sinus was seen in 37.3% of the cases. The distribution of the Borden classification was as follows: I (7.8%), II (37.3%), and III (54.9%). The endovascular techniques were transvenous embolization (TVE) alone (11.8%), transarterial embolization (TAE) alone (74.5%), and a combination thereof (13.7%).The types of embolic materials for TAE were a coil (25.5%), n-butyl-2-cyanoacrylate (NBCA) (33.3%), and Onyx (45.1%).The arterial pedicles for TAE included MMA (86.3%), STA (17.6%), and OA (9.8%). Direct surgical exposure for the alternative endovascular access was performed to the SSS (5.9%), MMA (3.9%), STA (5.9%), and OA (3.9%). Sinus angioplasty with or without stenting was done in 9.8% of the cases. Balloon-assisted Onyx TAE was done with proximal flow control (7.8%), collateral devascularization (5.9%), and sinus protection (3.9%). Complete occlusion was achieved in 86.3% of the cases while the number of endovascular sessions varied among patients: single (74.5%), double (15.7%), and triple (9.8%). The rate of a postoperative modified Rankin Scale (mRS) score of 0-2 was 89.3%, with morbidity and mortality rates of 7.8% and 3.9%, respectively. Two patients died, possibly due to postoperative acute SSS occlusion. Conclusion:The current systematic review disclosed several specific results, namely, the angioarchitectures of the SSS dAVF, the relationship between classification and hemorrhagic presentation, the diversity of treatment techniques, the association between the complete occlusion rate and the SSS condition, and the difficulty of achieving curable occlusion in a single session. These findings underscore the need for the development of endovascular techniques and devices to treat this challenging lesion. Improvements in adjunctive endovascular procedures, such as balloon-assisted techniques for Onyx TAE, may help support to the safe and effective obliteration of SSS dAVF. Keywords▶ dural arteriovenous fistula, endovascular intervention, superior sagittal sinusThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.

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Transarterial Embolization of Dural Arteriovenous Fistula in Superior Sagittal Sinus Under Bilateral External Carotid Artery Flow Control: Technical Note

Cited by 6 publications

References 17 publications

Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

Dural Arteriovenous Fistula within Superior Sagittal Sinus Wall with Direct Cortical Venous Drainage: A Systematic Literature Review

Manual superficial temporal artery compression using a circular plastic material for embolization of meningioma: illustrative case

A Comprehensive Analysis of Dural Arteriovenous Fistula Involving the Superior Sagittal Sinus: A Systematic Review

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