Direct transcranial coil and Onyx embolization of a dural arteriovenous fistula: Technical note and brief literature review |
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Institution: | 2. Department of Diagnostic and Therapeutic Neuroradiology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, France;3. Department of Neuroradiology, S. Anna Hospital, Ferrara, Italy;4. Department of Interventional Neuroradiology, Rothschild Foundation hospital, Paris, France;5. Department of Neurology, Hôpital Foch Suresnes FR, University of Versailles Saint Quentin-en-Yvelines, France |
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Abstract: | Intracranial high-grade dural arteriovenous fistulas (DAVFs) have higher bleeding rates compared to other intracranial vascular malformations. Endovascular treatment is usually recommended for high-grade lesions, aiming at a complete fistula obliteration. However, some patients have vascular abnormalities that limit endovascular access to the precise location of the shunt. Alternative techniques may be considered in this scenario. A middle-aged man presented with intracranial hypertension secondary to a high-grade DAVF. Because of vascular abnormalities precluding transvenous access to the intracranial venous circulation, the patient required treatment by a direct transcranial coil and Onyx embolization of the shunt. Direct transcranial cannulation of a dural sinus is an alternative and effective route for transvenous embolization of DAVFs, especially if abnormal venous anatomy precluding venous access to the required cranial venous system is identified. |
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Keywords: | Dural arteriovenous fistula Direct embolization Transarterial embolization Transvenous embolization |
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