Combined transarterial and transvenous embolization of anterior cranial fossa dural arteriovenous fistula

Masahiro Sugihara; Atsushi Fujita; Yusuke Ikeuchi; Tatsuo Hori; Masaaki Kohta; Kazuhiro Tanaka; Hidehito Kimura; Takashi Sasayama

doi:10.25259/SNI_487_2023

Combined transarterial and transvenous embolization of anterior cranial fossa dural arteriovenous fistula

Surg Neurol Int. 2023 Aug 4:14:277. doi: 10.25259/SNI_487_2023. eCollection 2023.

Authors

Masahiro Sugihara¹, Atsushi Fujita¹, Yusuke Ikeuchi¹, Tatsuo Hori¹, Masaaki Kohta¹, Kazuhiro Tanaka¹, Hidehito Kimura¹, Takashi Sasayama¹

Affiliation

¹ Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Abstract

Background: Excessive glue injection into the drainage vein in patients with dural arteriovenous fistula (dAVF) can result in venous obstruction. We performed transarterial embolization (TAE) combined with transvenous embolization (TVE) with coils to prevent the glue from migrating into the normal cortical veins.

Case description: A 57-year-old man was pointed out to have a Borden Type III anterior cranial fossa dAVF during a check-up for putaminal hemorrhage. Because a left frontal normal cortical vein drained into the pathological drainage vein, excessive glue injection into the drainage vein may have caused venous obstruction. We performed TVE with coils at the foot of the draining vein to prevent excessive migration of glue into the drainer, followed by TAE with glue. With this technique, complete obliteration of the shunt without venous ischemia was obtained.

Conclusion: The combined treatment of TAE and TVE is effective in preventing venous ischemia caused by unintended migration of glue cast into the drainage vein.

Keywords: Anterior cranial fossa; Combined treatment; Dural arteriovenous fistula; Transarterial embolization; Transvenous embolization.

Publication types

Case Reports