Transvenous Embolization of Intracranial Dural Arteriovenous Shunts through Occluded Venous Segments: Experience in 51 Patients

Abstract

BACKGROUND AND PURPOSE:DAVFs with cortical venous reflux carry a high risk of morbidity and mortality. Endovascular treatment options include transarterial embolization with a liquid embolic agent or transvenous access with occlusion of the involved venous segment, which may prove difficult if the venous access route is thrombosed. The aim of this article is to describe the technique and results of the transvenous approach via thrombosed venous segments for occlusion of DAVFs.

Blind endovascular catheterization and direct access of an occluded superior ophthalmic vein for treatment of carotid cavernous fistula

“…The trans-venous approach via the IPS was the first established route and is still the most commonly used method today 12 13. When the IPS cannot be visualized filling early through the fistula, or in the delayed venous phase, blind cannulation of the IPS has been widely used 14. In about 31% of patients, the IPS cannot be catheterized due to plexiform architecture 14 15.…”

Ophthalmic vein compression for selected benign low-flow cavernous sinus dural arteriovenous fistulas

“…13 Transvenous embolization has a high success rate in achieving closure of the fistula 11,16 and therefore is the treatment of choice. The most frequently used transvenous paths are via the inferior petrosal sinus, using a transfemoral venous approach, or via a cutdown to the SOV.…”

Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans–Facial Vein Embolization

“…Embolization of CCF by transarterial (8,9,13,18) or transeinferior petrous sinus (IPS) approach is a well-established treatment with promising results (10,17). However, transarterial and trans-IPS access routes may fail, or it may be difficult to achieve complete fistula closure in some CCFs with difficult fistula anatomy, such as a larger tear at the cavernous portion of the internal carotid artery (11) or occlusion or stenosis of the IPS (7). Transefacial vein (FV) access is an alternative for embolization of CCFs with anterior drainage to the superior ophthalmic vein (SOV) and FV.…”