Transvenous embolisation for cavernous dural arteriovenous shunts: case selection and methods of embolisation

  • A. Takahashi
  • M. Ezura
  • Y. Fujii
  • T. Yoshimoto
Conference paper

Abstract

To evaluate the efficacy of transvenous embolisation for cavernous dural arteriovenous shunts (CdAVS) as a primary treatment modality, angiographic classification based on the drainage system and embolisation methods were analysed. From May 1987 to March 1994, of 76 cases admitted we treated 53 cases (7 men, 46 women aged 38–85 years, average 64.3 years; bilateral lesions in 9) of CdAVS by transvenous embolisation. Based on the venous drainage pattern and shunting architecture, the appropriate approach and method of embolisation were selected. Sixty transvenous embolisation procedures (via the superior ophthalmic vein in 22, the inferior betrosal sinus in 36, both in 2) were performed. Immediately after embolisation, we achieved complete radioanatomical cure in 33 cases (62.3%). Complete cure rate at follow-up (average follow-up 8.9 months) was 94.3%. Complications included transient cavernous sinus syndrome in 8, redirection of venous flow in 2, posterior ischaemic optic neuropathy in 1, and cerebral infarction in 1. Transvenous embolisation for CdAVS would offer satisfactory therapeutic efficacy when applied considering venous drainage pattern and shunting architecture.

Key words

Dura mater Arteriovenous shunts Embolisation Vein Coils 

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References

  1. 1.
    Lasjaunias P, Chiu M, Terbrugge K, Tolia A, Hurth M, Berenstein A (1986) Neurological manifestations of intracranial dural arteriovenous malformations. J Neurosurg 64:724–730.PubMedCrossRefGoogle Scholar
  2. 2.
    Takahashi A, Yoshimoto T, Kawakami K, Sugawara T, Suzuki J (1989) Transvenous copper wire insertion for dural arteriovenous malformations of cavernous sinus. J Neurosurg 70:751–754.PubMedCrossRefGoogle Scholar
  3. 3.
    Suzuki J, Komatsu S (1981) New liquid embolisation method using estrogen for dural arteriovenous malformation and menin-giomas. Surg Neurol 16:438–442.PubMedCrossRefGoogle Scholar
  4. 4.
    Peterson EW, Valberg J, Whittingham DS (1969) Electrically induced thrombosis of the cavernous sinus in the treatment of carotid-cavernous fistula (abstract). In: Drake CG, Duvoisin R (eds) Proceedings of the Fourth International Congress Series, vol 193. Excerpta Medica, Amsterdam, p 105.Google Scholar
  5. 5.
    Teng MMH, Guo WY, Huang CI, Wu CC, Chang T (1988) Occlusion of arteriovenous malformation of the cavernous sinus via the superior ophthalmic vein. AJNR 9:539–546.PubMedGoogle Scholar
  6. 6.
    Halbach W, Higashida RT, Hieshima GB, Hardin CW, Pribram H (1989) Transvenous embolization of durai fistulas involving the cavernous sinus. AJNR 10:377–383.PubMedGoogle Scholar
  7. 7.
    Komiyama M, Morikawa K, Fu Y, Yagura H, Yasui T, Baba M (1990) Indirect carotid-cavernous sinus fistula: transvenous embolization from the external jugular vein using a superior ophthalmic vein approach. A case report. Surg Neurol 33:57–63.PubMedCrossRefGoogle Scholar
  8. 8.
    Halbach VV, Higashida RT, Hieshima GB, Hardin CW, Yang PJ (1988) Transvenous embolization of direct carotid cavernous fistulas. AJNR 9:741–747.PubMedGoogle Scholar
  9. 9.
    Yamashita K, Taki W, Nakahara I, Nishi S, Sadato A, Kikuchi H (1993) Development of sigmoid dural arteriovenous fistulas after transvenous embolization of cavernous dural arteriovenous fistulas. AJNR 14:1106–1108.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • A. Takahashi
    • 1
  • M. Ezura
    • 1
  • Y. Fujii
    • 1
  • T. Yoshimoto
    • 2
  1. 1.Division of Intravascular Neurosurgery, Department of NeurosurgeryKohnan HospitalSendaiJapan
  2. 2.Department of NeurosurgeryTohoku University of MedicineSendaiJapan

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