下錐体静脈洞の血管形成術

DOI

書誌事項

タイトル別名
  • PTA for Inferior Petrosal Sinus
  • In the Case of Cavernous Sinus Dural AVF
  • 海綿静脈洞部硬膜動静脈瘻において

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Transvenous embolization (TVE) is a standard treatment for cavernous sinus dural arteriovenous fistulas (CSDAVFs). Although the standard TVE technique, whole sinus packing with multiple coils, is highly effective, sinus packing can cause cranial nerve injury induced by the coil mass or disturbance of the normal venous drainage. Selective TVE, selective embolization of the shunted pouch, has been developed to deal with such complications, and it has been recently performed in selected cases of CSDAVF with localized shunted pouches. However, it has a potential risk of recurrence, and retreatment by TVE through the occluded inferior petrosal sinus (IPS) may be difficult. Angioplasty of the occluded IPS combined with selective TVE may reduce the difficulty of catheterization to the CS through the IPS when retreatment is required. Furthermore, angioplasty of the occluded IPS can reconstruct normal antegrade cerebral venous drainage through the IPS. In this paper, we will describe this combined technique, and some important anatomy of the cavernous sinus, inferior petrosal sinus, and relevant veins briefly.

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