Aggressive cavernous sinus dural arteriovenous fistula: Angioarchitecture analysis and embolization by various approaches

Journal of the Chinese Medical Association : JCMA
Chao-Bao LuoTa-Wei Ting

Abstract

Most cavernous sinus dural arteriovenous fistulas (CSDAVFs) present with benign neuro-ophthalmic symptoms. CSDAVFs manifesting with aggressive neurologic symptoms are rare. The purpose of this study was to analyze the different angioarchitectures of aggressive CSDAVFs and to report our experiences of embolization. Over the past 10 years, a total of 118 CSDAVFs were managed by embolization. From the databases containing such patient information, nine patients (7.6%) were found to have aggressive CSDAVFs presenting with neurologic deficits. There were seven women and two men, ranging in age from 51 years to 78 years (mean, 66 years). We retrospectively analyzed the angioarchitectures of aggressive CSDAVFs, further reviewing patient and angiographic as well clinical outcomes after embolization. The cause of clinically aggressive CSDAVFs was insufficient fistula drainage because of occlusion (n = 6) or stenosis (n = 1) of the inferior petrous sinus (IPS) or compartment of IPS-cavernous sinus (n = 2) with fistula flow reflux to the veins of brainstem (n = 7) leading to brainstem ischemia, while two fistula flow reflux to the cortical vein leading to cerebral infarction. Transvenous embolization via IPS to fistula was achieved in one...Continue Reading

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Mar 7, 2014·Journal of the Chinese Medical Association : JCMA·Chao-Bao LuoCheng-Yen Chang
Jul 15, 2015·Journal of the Chinese Medical Association : JCMA·Chao-Bao LuoTa-Wei Ting

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Citations

Aug 22, 2017·Journal of Neurointerventional Surgery·Luís Henrique de Castro-AfonsoDaniel Giansante Abud
Sep 1, 2018·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Luís Henrique de Castro-AfonsoDaniel G Abud
Jun 14, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Shuai ZhangMing Lv

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