Publication: Transvenous embolization of intracranial dural arteriovenous shunts through occluded venous segments: Experience in 51 patients
Issued Date
2011-10-01
Resource Type
ISSN
1936959X
01956108
01956108
Other identifier(s)
2-s2.0-80054042231
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Neuroradiology. Vol.32, No.9 (2011), 1738-1744
Suggested Citation
E. Lekkhong, S. Pongpech, K. Ter Brugge, P. Jiarakongmun, R. Willinsky, S. Geibprasert, T. Krings Transvenous embolization of intracranial dural arteriovenous shunts through occluded venous segments: Experience in 51 patients. American Journal of Neuroradiology. Vol.32, No.9 (2011), 1738-1744. doi:10.3174/ajnr.A2566 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12299
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Transvenous embolization of intracranial dural arteriovenous shunts through occluded venous segments: Experience in 51 patients
Other Contributor(s)
Abstract
BACKGROUND AND PURPOSE: DAVFs with cortical venous reflux carry a high risk of morbidity and mortality. Endovascular treatment options include transarterial embolization with a liquid embolic agent or transvenous access with occlusion of the involved venous segment, which may prove difficult if the venous access route is thrombosed. The aim of this article is to describe the technique and results of the transvenous approach via thrombosed venous segments for occlusion of DAVFs. MATERIALS AND METHODS: Our study was a retrospective analysis of 51 patients treated with a transvenous approach through an occluded sinus that was reopened by gentle rotational advancement of a 0.035-inch guidewire, which opened a path for a subsequently inserted microcatheter. RESULTS: Of 607 patients with DAVFs, the transvenous reopening technique was attempted in 62 patients in 65 sessions and was successful in 51 patients and 53 sessions. Immediate occlusion was seen in 42 patients; on follow-up, occlusion was seen in 49 patients, whereas 2 patients had reduced flow without cortical venous reflux. No permanent procedure-related morbidity was noted. CONCLUSIONS: The reopening technique to gain access to isolated venous pouches or the cavernous sinus for the treatment of DAVFs is a safe and effective treatment, which should be considered if transarterial approaches fail or are anticipated to result only in an incomplete anatomic cure.