Surgical cannulation of a cortical draining vein for endovascular treatment of a dural arteriovenous fistula of the cavernous sinus

Abstract Dural arteriovenous fistulas (DAVF) of the cavernous sinus most commonly present with ocular symptoms and can be observed or treated with endovascular approaches, surgery, or radiosurgery. Combined surgical–endovascular approaches have been used for fistulas that are not amenable to standar...

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Bibliographic Details
Published in:Journal of clinical neuroscience 2011-04, Vol.18 (4), p.576-578
Main Authors: Thomas, Jonathan G, Chern, Joshua J, Mawad, Michel E, Duckworth, Edward A.M
Format: Article
Language:English
Subjects:
Adult
Arteriovenous fistula
Catheterization - methods
Cavernous Sinus - surgery
Central Nervous System Vascular Malformations - surgery
Craniotomy
Dural arteriovenous fistula
Embolization, Therapeutic - methods
Humans
Male
Neurology
Neurosurgical Procedures - methods
Surgical approaches
Sylvian vein
Transvenous
Vascular Surgical Procedures - methods
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Summary:Abstract Dural arteriovenous fistulas (DAVF) of the cavernous sinus most commonly present with ocular symptoms and can be observed or treated with endovascular approaches, surgery, or radiosurgery. Combined surgical–endovascular approaches have been used for fistulas that are not amenable to standard endovascular approaches. A 40-year-old man presented with ocular symptoms from a cavernous sinus DAVF. Multiple previous transarterial and transvenous embolization attempts had failed. The patient underwent craniotomy for surgical exposure and cannulation of an arterialized sylvian vein. Subsequently he underwent coiling and onyx embolization of the DAVF. The intervention resulted in effective obliteration of the fistula. If a cavernous sinus DAVF is refractory to treatment, surgical exposure and cannulation of a cortical draining vein can facilitate transvenous endovascular treatments.
ISSN:0967-5868
1532-2653
DOI:10.1016/j.jocn.2010.08.011