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Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula
Dural arteriovenous fistulas (DAVFs) are acquired pathological arteriovenous connections involving vessels that usually supply the meninges. A DAVF in the region of the hypoglossal canal is a rare form of fistula that involves the anterior condylar confluence or anterior condylar vein. We report a c...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Interventional Neuroradiology
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8561036/ https://www.ncbi.nlm.nih.gov/pubmed/34662933 http://dx.doi.org/10.5469/neuroint.2021.00367 |
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author | Padhi, Rasmiranjan Kandasamy, Sathish Kumaran, Balasenthil Kocer, Naci Karmadhari, Harshith |
author_facet | Padhi, Rasmiranjan Kandasamy, Sathish Kumaran, Balasenthil Kocer, Naci Karmadhari, Harshith |
author_sort | Padhi, Rasmiranjan |
collection | PubMed |
description | Dural arteriovenous fistulas (DAVFs) are acquired pathological arteriovenous connections involving vessels that usually supply the meninges. A DAVF in the region of the hypoglossal canal is a rare form of fistula that involves the anterior condylar confluence or anterior condylar vein. We report a case of hypoglossal canal DAVF that was successfully embolized transvenously through a superior ophthalmic vein (SOV) approach. After failed attempts through jugular access, our patient was treated by a unique percutaneous direct puncture approach through the SOV, achieving complete obliteration of the fistula. A step-by-step description of the endovascular technique was described. The clinical course was uneventful without any new neurologic deficit. The eye symptoms and third nerve palsy had completely resolved at the 3-month follow-up visit. Hypoglossal canal DAVFs are rare and may exhibit complex venous drainage patterns. Knowledge of the complex venous anatomy is essential for planning an alternative transvenous route if the standard approach is not feasible. Xper CT (Philips Healthcare, Best, The Netherlands) is an excellent tool for identifying the exact site of the fistula as well as for confirming a safe position of the catheter tip for successful occlusion of this complex dural AV fistula. |
format | Online Article Text |
id | pubmed-8561036 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Korean Society of Interventional Neuroradiology |
record_format | MEDLINE/PubMed |
spelling | pubmed-85610362021-11-12 Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula Padhi, Rasmiranjan Kandasamy, Sathish Kumaran, Balasenthil Kocer, Naci Karmadhari, Harshith Neurointervention Technical Note Dural arteriovenous fistulas (DAVFs) are acquired pathological arteriovenous connections involving vessels that usually supply the meninges. A DAVF in the region of the hypoglossal canal is a rare form of fistula that involves the anterior condylar confluence or anterior condylar vein. We report a case of hypoglossal canal DAVF that was successfully embolized transvenously through a superior ophthalmic vein (SOV) approach. After failed attempts through jugular access, our patient was treated by a unique percutaneous direct puncture approach through the SOV, achieving complete obliteration of the fistula. A step-by-step description of the endovascular technique was described. The clinical course was uneventful without any new neurologic deficit. The eye symptoms and third nerve palsy had completely resolved at the 3-month follow-up visit. Hypoglossal canal DAVFs are rare and may exhibit complex venous drainage patterns. Knowledge of the complex venous anatomy is essential for planning an alternative transvenous route if the standard approach is not feasible. Xper CT (Philips Healthcare, Best, The Netherlands) is an excellent tool for identifying the exact site of the fistula as well as for confirming a safe position of the catheter tip for successful occlusion of this complex dural AV fistula. Korean Society of Interventional Neuroradiology 2021-11 2021-10-19 /pmc/articles/PMC8561036/ /pubmed/34662933 http://dx.doi.org/10.5469/neuroint.2021.00367 Text en Copyright © 2021 Korean Society of Interventional Neuroradiology https://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/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Technical Note Padhi, Rasmiranjan Kandasamy, Sathish Kumaran, Balasenthil Kocer, Naci Karmadhari, Harshith Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula |
title | Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula |
title_full | Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula |
title_fullStr | Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula |
title_full_unstemmed | Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula |
title_short | Direct Superior Ophthalmic Vein Approach to Treat Anterior Condylar Confluence Dural Arteriovenous Fistula |
title_sort | direct superior ophthalmic vein approach to treat anterior condylar confluence dural arteriovenous fistula |
topic | Technical Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8561036/ https://www.ncbi.nlm.nih.gov/pubmed/34662933 http://dx.doi.org/10.5469/neuroint.2021.00367 |
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