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Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula

Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, hig...

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Autores principales: Kawabata, Shuhei, Nakamura, Hajime, Nishida, Takeo, Takagaki, Masatoshi, Izutsu, Nobuyuki, Takenaka, Tomofumi, Terada, Eisaku, Oshino, Satoru, Kishima, Haruhiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573859/
https://www.ncbi.nlm.nih.gov/pubmed/33123340
http://dx.doi.org/10.1093/jscr/rjaa327
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author Kawabata, Shuhei
Nakamura, Hajime
Nishida, Takeo
Takagaki, Masatoshi
Izutsu, Nobuyuki
Takenaka, Tomofumi
Terada, Eisaku
Oshino, Satoru
Kishima, Haruhiko
author_facet Kawabata, Shuhei
Nakamura, Hajime
Nishida, Takeo
Takagaki, Masatoshi
Izutsu, Nobuyuki
Takenaka, Tomofumi
Terada, Eisaku
Oshino, Satoru
Kishima, Haruhiko
author_sort Kawabata, Shuhei
collection PubMed
description Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, high blood flow from the internal maxillary artery (IMA) often impedes penetration of embolic materials into the shunt pouch. Therefore, reducing blood flow from the IMA before embolization can increase the success rate. In the present case, to reduce blood flow from branches of the IMA, we inserted surgical gauze infiltrated with xylocaine and epinephrine into bilateral nasal cavities. Using this method, we achieved curative TAE with minimal damage to the nasal mucosa. Transnasal flow reduction is an easy, effective and minimally invasive method. This method should be considered in the endovascular treatment of ACF–dAVF, especially in patients with high blood flow from theIMA.
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spelling pubmed-75738592020-10-28 Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula Kawabata, Shuhei Nakamura, Hajime Nishida, Takeo Takagaki, Masatoshi Izutsu, Nobuyuki Takenaka, Tomofumi Terada, Eisaku Oshino, Satoru Kishima, Haruhiko J Surg Case Rep Case Report Transarterial embolization (TAE) is a useful option for anterior cranial fossa–dural arteriovenous fistula (ACF–dAVF) as endovascular devices have progressed. Liquid agents are usually injected via a microcatheter positioned just proximal to the shunt pouch beyond the ophthalmic artery; however, high blood flow from the internal maxillary artery (IMA) often impedes penetration of embolic materials into the shunt pouch. Therefore, reducing blood flow from the IMA before embolization can increase the success rate. In the present case, to reduce blood flow from branches of the IMA, we inserted surgical gauze infiltrated with xylocaine and epinephrine into bilateral nasal cavities. Using this method, we achieved curative TAE with minimal damage to the nasal mucosa. Transnasal flow reduction is an easy, effective and minimally invasive method. This method should be considered in the endovascular treatment of ACF–dAVF, especially in patients with high blood flow from theIMA. Oxford University Press 2020-10-20 /pmc/articles/PMC7573859/ /pubmed/33123340 http://dx.doi.org/10.1093/jscr/rjaa327 Text en Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Report
Kawabata, Shuhei
Nakamura, Hajime
Nishida, Takeo
Takagaki, Masatoshi
Izutsu, Nobuyuki
Takenaka, Tomofumi
Terada, Eisaku
Oshino, Satoru
Kishima, Haruhiko
Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
title Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
title_full Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
title_fullStr Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
title_full_unstemmed Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
title_short Transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
title_sort transnasal flow reduction in endovascular treatment for anterior cranial fossa dural arteriovenous fistula
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573859/
https://www.ncbi.nlm.nih.gov/pubmed/33123340
http://dx.doi.org/10.1093/jscr/rjaa327
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