Superselective shunt occlusion for the treatment of cavernous sinus dural arteriovenous fistulae

Tetsu Satow, Kenichi Murao, Toshinori Matsushige, Kenji Fukuda, Susumu Miyamoto, Koji Iihara

研究成果: ジャーナルへの寄稿学術誌査読

24 被引用数 (Scopus)


BACKGROUND: In treating cavernous sinus dural arteriovenous fistulae (CSdAVFs), transvenous embolization of the whole affected sinus is usually performed, which may result in the disturbance of normal venous drainage or permanent cranial nerve palsy. OBJECTIVE: To describe superselective shunt occlusion of CSdAVFs. METHODS: Between July 2005 and August 2011, we had 20 consecutive cases of CSdAVFs. In 14 cases (70%), we could detect the restricted locus of arteriovenous shunts by 3-dimensional rotational angiography and/or superselective arteriography. After navigating the microcatheter to the shunt segment, consecutive superselective arteriovenography was performed to confirm the location of the microcatheter at the proper position. RESULTS: In 12 of 14 cases (85.7%) in which the shunt was restricted, coiling only in the small venous pouch or compartment, which was just downstream of the shunt point, led to complete disappearance of the shunt without obliterating the entire sinus. No recurrence or permanent cranial nerve palsy was observed during the follow-up period with a mean of 46 months (range, 3-69 months) in 12 cases treated by superselective shunt occlusion. CONCLUSION: This technique, which enables complete extirpation of shunts by small amounts of coils, is a feasible way to treat CSdAVFs with excellent mid- to long-term results. Understanding of the angioarchitecture by 3-dimensional rotational angiography and consecutive superselective arteriovenography was useful. This method should be considered before sinus packing or mere obliteration of dangerous venous outlets.

ジャーナルOperative Neurosurgery
出版ステータス出版済み - 2013

!!!All Science Journal Classification (ASJC) codes

  • 外科
  • 臨床神経学


「Superselective shunt occlusion for the treatment of cavernous sinus dural arteriovenous fistulae」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。