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Titolo:
Endovascular treatment of a grade IV transverse sinus dural arteriovenous fistula by sinus recanalization, angioplasty, and stent placement: Technical case report
Autore:
Murphy, KJ; Gailloud, P; Venbrux, A; Deramond, H; Hanley, D; Rigamonti, D;
Indirizzi:
Johns Hopkins Hosp, Dept Radiol & Radiol Sci, Neurointens Care Unit, Baltimore, MD 21287 USA Johns Hopkins Hosp Baltimore MD USA 21287 e Unit, Baltimore, MD 21287 USA Johns Hopkins Hosp, Cardiovasc Diagnost Lab, Baltimore, MD 21287 USA JohnsHopkins Hosp Baltimore MD USA 21287 st Lab, Baltimore, MD 21287 USA Johns Hopkins Hosp, Dept Neurol & Cerebrovasc Surg, Baltimore, MD 21287 USA Johns Hopkins Hosp Baltimore MD USA 21287 c Surg, Baltimore, MD 21287 USA Johns Hopkins Hosp, Dept Neurosurg, Baltimore, MD 21287 USA Johns Hopkins Hosp Baltimore MD USA 21287 rosurg, Baltimore, MD 21287 USA
Titolo Testata:
NEUROSURGERY
fascicolo: 2, volume: 46, anno: 2000,
pagine: 497 - 500
SICI:
0148-396X(200002)46:2<497:ETOAGI>2.0.ZU;2-7
Fonte:
ISI
Lingua:
ENG
Soggetto:
CLASSIFICATION; HYPERTENSION; EMBOLIZATION;
Keywords:
balloon angioplasty; dural arteriovenous fistula; interventional neuroradiology; intracranial venous hypertension; stents; venous sinus thrombosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
12
Recensione:
Indirizzi per estratti:
Indirizzo: Murphy, KJ Johns Hopkins Hosp, Dept Radiol & Radiol Sci, Neurointens Care Unit, 600 NWolfe St, Baltimore, MD 21287 USA Johns Hopkins Hosp 600 N WolfeSt Baltimore MD USA 21287 87 USA
Citazione:
K.J. Murphy et al., "Endovascular treatment of a grade IV transverse sinus dural arteriovenous fistula by sinus recanalization, angioplasty, and stent placement: Technical case report", NEUROSURGER, 46(2), 2000, pp. 497-500

Abstract

OBJECTIVE AND IMPORTANCE: The frequent association of dural arteriovenous fistulae (DAVFs) and dural sinus thrombosis may render the treatment of these complex lesions difficult. We report a case of DAVF eradicated by recanalization of the chronically thrombosed transverse sinus (TS) and sigmoid sinus followed by balloon angioplasty and stent deployment at the site of thefistula. CLINICAL PRESENTATION: A 52-year-old man presented with a Type IV DAVF of the left TS with widespread white matter changes secondary to venous hypertension. Arterial feeders arose from the left internal carotid, external carotid, and vertebral arteries. The distal segment of the left TS, the left sigmoid sinus, and the proximal segment of the right TS were occluded. Reverse flow was observed in the deep venous system and in the superior sagittalsinus. INTERVENTION: Endovascular access was gained through the left internal jugular vein. Mechanical recanalization of the thrombosed left TS and sigmoid sinus was followed by balloon angioplasty and placement of six overlapping stents extending from the TS to the proximal internal jugular vein. Angiograms performed after surgery showed resaturation of antegrade venous drainage as well as complete eradication of the fistulous connections. The patientwas discharged with an improving clinical status. CONCLUSION: Recanalization of a chronically occluded dural venous sinus through a jugular approach is feasible. In addition to eradicating cerebral venous hypertension by reestablishing antegrade venous drainage, balloon angioplasty and stent deployment at the DAVF site produced complete closure ofthe fistula. This may prove to be a new therapeutic strategy for management of DAVF.

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Documento generato il 04/12/20 alle ore 09:54:24