An Approach to Superior Petrosal Sinus via Contralateral Superior Petrosal Sinus in a Case of Dural Arteriovenous Fistulas with Difficulty in Access

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Other Title
  • アクセス困難な硬膜動静脈瘻症例における，対側上錐体静脈洞を経由する上錐体静脈洞へのアプローチ
  • アクセス コンナン ナ コウマクドウ ジョウミャクロウショウレイ ニ オケル,タイソク ジョウ スイタイ ジョウミャクドウ オ ケイユ スル ジョウ スイタイ ジョウミャクドウ エ ノ アプローチ

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<p>Objective: Herein, we report a case of multiple dural arteriovenous fistulas (DAVFs) in the left superior petrosal sinus (SPS) successfully treated by transvenous embolization via the right SPS.</p><p>Case Presentation: A 60-year-old woman was diagnosed with multiple DAVFs with deep venous reflux to evaluate consciousness disturbance. We performed packing of the left transverse sinus, which was chiefly involved in reflux to the straight sinus. However, consciousness continued to be mildly disturbed, and DSA was performed again. A shunt was inserted into the left SPS, and the subsequently occurring deep venous reflux was clearly revealed. Because the ipsilateral transverse sinus and both inferior petrosal sinuses were already occluded and unavailable as access routes, we used the contralateral SPS and both cavernous sinuses to navigate the microcatheter into the shunt. We achieved occlusion of the SPS and stopped the reflux by inserting the intermediate catheter firmly into the bilateral SPS.</p><p>Conclusion: An access route through the contralateral SPS might successfully enable transvenous embolization of DAVF cases without an ipsilateral access route.</p>

Journal

  • No Kekkannai Chiryo

    No Kekkannai Chiryo 6 (3), 161-168, 2021

    The Japanese Society for Neuroendovascular Therapy

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