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Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report

BACKGROUND: Although the inferior petrosal sinus (IPS) is the most common approach route for transvenous embolization (TVE) of cavernous sinus dural arteriovenous fistulas (CSDAVFs), other routes should be chosen in cases which the IPS is occluded. We report a case in which the superior ophthalmic v...

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Autores principales: Kuwajima, Takuto, Beppu, Mikiya, Maeda, Kazuhiko, Okada, Yoichiro, Kohno, Ryuichi, Yoshimura, Shinichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408603/
https://www.ncbi.nlm.nih.gov/pubmed/37560591
http://dx.doi.org/10.25259/SNI_455_2023
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author Kuwajima, Takuto
Beppu, Mikiya
Maeda, Kazuhiko
Okada, Yoichiro
Kohno, Ryuichi
Yoshimura, Shinichi
author_facet Kuwajima, Takuto
Beppu, Mikiya
Maeda, Kazuhiko
Okada, Yoichiro
Kohno, Ryuichi
Yoshimura, Shinichi
author_sort Kuwajima, Takuto
collection PubMed
description BACKGROUND: Although the inferior petrosal sinus (IPS) is the most common approach route for transvenous embolization (TVE) of cavernous sinus dural arteriovenous fistulas (CSDAVFs), other routes should be chosen in cases which the IPS is occluded. We report a case in which the superior ophthalmic vein (SOV) approach through the facial vein (FV) was the first choice to achieve radical cure of a hemorrhage-onset CSDAVF. CASE DESCRIPTION: An 81-year-old female presented with a history of transarterial embolization (TAE) and TVE for the left CSDAVF 27 years ago. She was transported to us with a chief complaint of consciousness disturbance, and head computed tomography (CT) showed subcortical hemorrhage in the right frontal lobe. Cerebral angiography revealed CSDAVF with draining into the right SOV and right superficial middle cerebral vein (SMCV). Angiography, computed tomography venography, and contrast-enhanced magnetic resonance imaging did not show IPS, but the outflow pathways to the SOV, FV, and internal jugular vein were confirmed, so an approach through the FV was selected. CONCLUSION: The FV was selected through the right femoral vein and thanks to the distal access catheter (DAC) being guided to the SOV, the microcatheter could be easily guided to the SMCV through the cavernous sinus (CS). TVE was performed, complete occlusion was confirmed. When preoperative occlusion of the IPS was confirmed, the FV was useful for the first choice of route, and the use of DAC allowed us to complete the treatment accurately and quickly.
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spelling pubmed-104086032023-08-09 Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report Kuwajima, Takuto Beppu, Mikiya Maeda, Kazuhiko Okada, Yoichiro Kohno, Ryuichi Yoshimura, Shinichi Surg Neurol Int Case Report BACKGROUND: Although the inferior petrosal sinus (IPS) is the most common approach route for transvenous embolization (TVE) of cavernous sinus dural arteriovenous fistulas (CSDAVFs), other routes should be chosen in cases which the IPS is occluded. We report a case in which the superior ophthalmic vein (SOV) approach through the facial vein (FV) was the first choice to achieve radical cure of a hemorrhage-onset CSDAVF. CASE DESCRIPTION: An 81-year-old female presented with a history of transarterial embolization (TAE) and TVE for the left CSDAVF 27 years ago. She was transported to us with a chief complaint of consciousness disturbance, and head computed tomography (CT) showed subcortical hemorrhage in the right frontal lobe. Cerebral angiography revealed CSDAVF with draining into the right SOV and right superficial middle cerebral vein (SMCV). Angiography, computed tomography venography, and contrast-enhanced magnetic resonance imaging did not show IPS, but the outflow pathways to the SOV, FV, and internal jugular vein were confirmed, so an approach through the FV was selected. CONCLUSION: The FV was selected through the right femoral vein and thanks to the distal access catheter (DAC) being guided to the SOV, the microcatheter could be easily guided to the SMCV through the cavernous sinus (CS). TVE was performed, complete occlusion was confirmed. When preoperative occlusion of the IPS was confirmed, the FV was useful for the first choice of route, and the use of DAC allowed us to complete the treatment accurately and quickly. Scientific Scholar 2023-07-07 /pmc/articles/PMC10408603/ /pubmed/37560591 http://dx.doi.org/10.25259/SNI_455_2023 Text en Copyright: © 2023 Surgical Neurology International https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
Kuwajima, Takuto
Beppu, Mikiya
Maeda, Kazuhiko
Okada, Yoichiro
Kohno, Ryuichi
Yoshimura, Shinichi
Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report
title Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report
title_full Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report
title_fullStr Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report
title_full_unstemmed Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report
title_short Cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: A case report
title_sort cavernous sinus dural arteriovenous fistula treated with transvenous embolization through facial vein: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10408603/
https://www.ncbi.nlm.nih.gov/pubmed/37560591
http://dx.doi.org/10.25259/SNI_455_2023
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