A Case of Anterior Condylar Confluence Dural Arteriovenous Fistula with Ocular Symptoms Cured with Transvenous Embolization via the Facial Vein

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  • KAWABE Keita
    Department of Neurosurgery, Brain Research Institute, Niigata University
  • HASEGAWA Hitoshi
    Department of Neurosurgery, Brain Research Institute, Niigata University
  • KIKUCHI Bunpei
    Department of Neurosurgery, Brain Research Institute, Niigata University
  • ITO Yasushi
    Department of Neurosurgery, Shinrakuen Hospital
  • JIMBO Yasushi
    Department of Neurosurgery, Nagaoka Red Cross Hospital
  • OISHI Makoto
    Department of Neurosurgery, Brain Research Institute, Niigata University
  • FUJII Yukihiko
    Department of Neurosurgery, Brain Research Institute, Niigata University

Bibliographic Information

Other Title
  • 顔面静脈経由による経静脈的塞栓術で治療した眼症状を有する Anterior Condylar Confluence 近傍硬膜動静脈瘻の1例
  • 症例報告 顔面静脈経由による経静脈的塞栓術で治療した眼症状を有するAnterior Condylar Confluence近傍硬膜動静脈瘻の1例
  • ショウレイ ホウコク ガンメン ジョウミャク ケイユ ニ ヨル ケイ ジョウミャクテキ ソクセンジュツ デ チリョウ シタ ガン ショウジョウ オ ユウスル Anterior Condylar Confluence キンボウコウマクドウ ジョウミャクロウ ノ 1レイ

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Abstract

<p>Objective: We report a case of anterior condylar confluence (ACC) dural arteriovenous fistula (DAVF) with ocular symptoms cured with transvenous embolization via the facial vein.</p><p>Case Presentation: The patient was a 52-year-old man who had pulsatile tinnitus 5 years ago that cured spontaneously. He had developed conjunctival hyperemia, exophthalmos, and diplopia 1 month before admission. Magnetic resonance angiography and digital subtraction angiography showed the shunt point was the ACC, and the main venous drainage route was retrograde from the cavernous sinus to the superior orbital vein due to obstruction of the antegrade drainage route. We performed transvenous embolization by re-opening channels from the internal jugular vein to the ACC, but it failed. Then, we tried the trans-facial vein approach. The triple coaxial catheter system consisted of a 6-Fr guiding catheter, a 4-Fr intermediate catheter, and a micro-catheter that allowed us to use a long distance approach to the ACC with good supporting force. We successfully performed transvenous coil embolization via the facial vein, and the patient's ocular symptoms improved immediately.</p><p>Conclusion: Transvenous embolization via the facial vein using the triple coaxial catheter system will be useful for similar ACC DAVF cases.</p>

Journal

  • No Kekkannai Chiryo

    No Kekkannai Chiryo 5 (2), 86-92, 2020

    The Japanese Society for Neuroendovascular Therapy

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