Intraosseous Cranial Dural Arteriovenous Fistula Treated with Transvenous Embolization

Overview

Journal AJNR Am J Neuroradiol

Specialty Neurology

Date 2009 Feb 28

PMID 19246532

Citations 20

Authors

C Jung

B J Kwon

O-K Kwon

S K Baik

M H Han

J E Kim

C W Oh

Affiliations

Soon will be listed here.

Abstract

Background And Purpose: We analyzed the angiographic architecture of intraosseous dural arteriovenous fistulas (DAVFs) and evaluated the use of transvenous embolization for curative treatment.

Materials And Methods: The study population consisted of 6 patients with intraosseous DAVFs from 3 hospitals. In all of these patients, we retrospectively reviewed the medical records and images, and we were able to confirm the lesions in all patients from CT, MR imaging, and angiographic images. 3D rotational angiographic coronal source images clearly demonstrated the presence of an intraosseous DAVF in 2 patients.

Results: An intraosseous DAVF was located at the upper clivus in 1, the petrous apex in 1, and the lower clivus adjacent to the hypoglossal canal in 4 cases. All of the cases showed the presence of a dilated venous pouch, manifest as an osteolytic lesion on CT and as an intraosseous signal-intensity void on MR images. All patients were treated with transvenous embolization by targeting the dilated venous pouch and its connecting tributaries. Four intraosseous DAVFs were immediately completely embolized. One patient had a residual shunt, but the shunt disappeared 1 month later. One patient presented with a simultaneous DAVF in the ipsilateral cavernous sinus without a significant amount of shunt. None of the patients had procedural complications, and 5 patients recovered from the presenting symptoms.

Conclusions: An intraosseous DAVF could be completely cured with transvenous embolization. For curative treatment, the intraosseous dilated venous pouch can be the target lesion for endovascular treatment.

Citing Articles

A Case of an Intraosseous Arteriovenous Fistula at the Squamous Part of the Occipital Bone with Spontaneous Occlusion of Diploic Venous Drainage.

Irizato N, Asai K, Okubata H, Tateishi A, Taniguchi M, Wakayama A J Neuroendovasc Ther. 2024; 18(9):240-244.

PMID: 39309173 PMC: 11412771. DOI: 10.5797/jnet.cr.2024-0027.

Transvenous embolization of noncavernous dural arteriovenous fistulas (dAVFs): A systematic review and meta-analysis.

Lim J, Donnelly B, Jaikumar V, Kruk M, Kuo C, Monteiro A Interv Neuroradiol. 2024; :15910199241234098.

PMID: 38414437 PMC: 11571326. DOI: 10.1177/15910199241234098.

Transvenous embolization for an intraosseous clival arteriovenous fistula via a proper access route guiding a three-dimensional fusion image: illustrative case.

Iida Y, Suenaga J, Shimizu N, Shizawa K, Suzuki R, Miyake S J Neurosurg Case Lessons. 2023; 6(18).

PMID: 37903421 PMC: 10618065. DOI: 10.3171/CASE23492.

Dural Arteriovenous Fistulas in the Parasellar Region Other Than the Cavernous Sinus.

Hiramatsu M, Sugiu K, Haruma J, Hishikawa T, Takahashi Y, Murai S J Neuroendovasc Ther. 2023; 14(12):593-604.

PMID: 37502140 PMC: 10370661. DOI: 10.5797/jnet.ra.2020-0042.

A Case of Intraosseous Petrous Bone Arteriovenous Fistula Complicated by Transient Worsening of Ipsilateral Hearing Following Transvenous Coil Embolization.

Satoh D, Sasaki T, Yako T, Kitazawa K, Kobayashi S J Neuroendovasc Ther. 2023; 16(1):26-32.

PMID: 37502024 PMC: 10370621. DOI: 10.5797/jnet.cr.2020-0190.

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