Percutaneous transvenous embolization of transverse / sigmoid sinus dural arteriovenous fistula through the mastoid emissary vein: case report

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  • HIRAMATSU Masafumi
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • SUGIU Kenji
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • TOKUNAGA Koji
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • NISHIDA Ayumi
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • HAYASE Hitoshi
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • MIYOSHI Yasuyuki
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • FUJIWARA Kenjiro
    Department of Neurological Surgery, Kosei General Hospital
  • NAKAGAWA Minoru
    Department of Neurological Surgery, Kosei General Hospital
  • DATE Isao
    Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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Other Title
  • 後頭部皮下静脈穿刺による横・S状静脈洞部硬膜動静脈瘻の塞栓術：症例報告

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Objective: Percutaneous transvenous embolization (TVE) of a transverse/sigmoid sinus dural arteriovenous fistula (TS/SS dAVF) through the mastoid emissary vein (MEV) is reported.<br>Case presentation: A 46-year-old man was admitted to our hospital for cerebral venous infarction. Angiography revealed left TS/SS dAVF with isolated sinus and retrograde cortical venous reflux. Transarterial embolization resulted in successful reduction of the shunt flow and improvement of the clinical symptoms. Transvenous approach through the occluded dural sinus into the affected sinus failed. Direct puncture of the dilated occipital vein was then performed, and TVE using coils was performed successfully through the MEV. This procedure resulted in complete disappearance of the dAVF.<br>Conclusion: This technique is a simple and good alternative treatment in patients for whom conventional approach to the isolated sinus is difficult to adopt, if there is the drainage of the dilated mastoid emissary vein.

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