Transvenous embolization of indirect carotid-cavernous fistula via puncture of the cubital vein and distal radial artery

Gegenava, B. B.; Dzhindzhikhadze, R. S.; Шумаков, Д. В.; Гришина, Е. Е.; Kapranov, Maxim S.; Kurnosov, S. A.

doi:10.1016/j.radcr.2020.04.047

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Under general anesthesia and while fully heparinized (3,000 IU as a bolus and 1,000 IU/h as a continuous infusion to keep the activated clotting time to three to four times the normal rate), both transarterial and transvenous femoral or radial approaches are performed ( 23 , 30 , 37 ). Through the transarterial path, a diagnostic catheter is positioned in the carotid artery as the dominant feeding artery of the CS-DAVF to provide a forward venous roadmap ( 10 ).…”

Section: Procedures Of Transfemoral Trans-fv-sov Routementioning

confidence: 99%

Transfemoral trans-facial vein-superior ophthalmic vein to embolize cavernous sinus dural arteriovenous fistulas

Zhou

2023

Front. Neurol.

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Cavernous sinus dural arteriovenous fistula (CS-DAVF) is an abnormal communication between the CS and dural arteries from the internal carotid artery and external carotid artery. CS-DAVFs are not uncommon. The preferred treatment for most CS-DAVFs is transvenous embolization (TVE), which can achieve a high cure rate with few complications. The trans-inferior petrous sinus (IPS) route from the internal jugular vein to the CS is the favorite and most direct route to perform TVE in the great majority of CS-DAVFs. However, when the trans-IPS route fails and if the facial vein (FV) is patent and dilated, transfemoral trans-FV-superior ophthalmic vein (SOV) embolization of the CS-DAVF can be attempted. However, the transfemoral trans-FV-SOV route to embolize CS-DAVFs is often challenging, and there is insufficient knowledge about it. Therefore, an updated review of the transfemoral trans-FV-SOV route to embolize CS-DAVFs is necessary, and this review includes our experience. The images in this review are from our institute without the dispute of copyright. Issues regarding the transfemoral trans-FV-SOV route to embolize CS-DAV were discussed, including the FV anatomy and variation, various TVE routes to access CS-DAVF, the procedure of the transfemoral trans-FV-SOV route to embolize CS-DAVF, difficulty, and solution of the transfemoral trans-FV-SOV route to embolize CS-DAVF, and complications and prognosis of transfemoral trans-FV-SOV to embolize CS-DAVF. By reviewing the transfemoral trans-FV-SOV route to embolize CS-DAVFs, we found that this route provides a valuable alternative to the other transvenous routes. A good prognosis can be obtained with the transfemoral trans-FV-SOV route to embolize CS-DAVFs in select cases.

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Section: Procedures Of Transfemoral Trans-fv-sov Routementioning

confidence: 99%

Transfemoral trans-facial vein-superior ophthalmic vein to embolize cavernous sinus dural arteriovenous fistulas

Zhou

2023

Front. Neurol.

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Transvenous embolization of noncavernous dural arteriovenous fistulas (dAVFs): A systematic review and meta-analysis

Lim,

Donnelly,

Jaikumar

et al. 2024

Interv Neuroradiol

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Background Intracranial dural arteriovenous fistulas (dAVFs) are abnormal connections between arteries and veins within the dura mater. Various treatment modalities, such as surgical ligation, endovascular intervention, and radiosurgery, aim to close the fistulous connection. Although transvenous embolization (TVE) is the preferred method for carotid-cavernous fistulas, its description and outcomes for noncavernous dAVFs vary. This has prompted a systematic review and meta-analysis to comprehensively assess the effectiveness of TVE in treating noncavernous dAVFs, addressing variations in outcomes and techniques. Methods We searched PubMed and Embase, spanning from the earliest records to December 2022, to identify pertinent English-language articles detailing the utilization of TVE. We focused on specific procedural details, outcomes, and complications in patients older than 18 years. The data collected and analyzed comprised the sample size, number of fistulas, publication specifics, presenting symptoms, fistula grades, and pooled rates of embolizations, outcomes, follow-up information, and complications. Results From a total of 565 screened articles, 15 retrospective articles encompassing 166 patients spanning across seven countries met the inclusion criteria. Their Newcastle–Ottawa scores ranged from 6 to 8. Intraprocedural complication rate was 10% (95% confidence interval [CI] = 5.9–17.1) and in-hospital postprocedural complication rate was 5.4% (95% CI = 2.8–10.6). Prevalence of in-hospital mortality was 5.5% (95% CI = 2.9–10.6). Complication rate during follow-up was 8.6% (95% CI = 4.7–15.7) with fistula rupture occurring in 5.5% (95% CI = 2.6–11.6) of patients. Complete obliteration rate at final angiographic follow-up was 94.9% (95% CI = 90.3–99.9). Symptoms improved in 95% (95% CI = 89.8–100) of patients at final follow-up. Conclusion To our knowledge, we present the first meta-analysis assessing obliteration rates, outcomes, and complications of TVE for dAVFs. Our analysis highlights the higher (>90%) complete obliteration rates. Large prospective multicenter studies are needed to better define the utility of TVE for noncavernous dAVFs.

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Transvenous embolization of indirect carotid-cavernous fistula via puncture of the cubital vein and distal radial artery

Cited by 2 publications

References 12 publications

Transfemoral trans-facial vein-superior ophthalmic vein to embolize cavernous sinus dural arteriovenous fistulas

Transfemoral trans-facial vein-superior ophthalmic vein to embolize cavernous sinus dural arteriovenous fistulas

Transvenous embolization of noncavernous dural arteriovenous fistulas (dAVFs): A systematic review and meta-analysis

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