Percutaneous transvenous embolization of a dural arteriovenous fistula through a mastoid emissary vein. Technical note.
Definitive endovascular treatment of dural arteriovenous fistulas (DAVFs) requires obliteration of the site of the fistula: either the diseased dural sinus or the pial vein. Access to this site is often limited by occlusion of the sinus proximal and distal to the segment containing the fistula. The authors describe a technique in which the mastoid emissary vein is used to gain access to a Borden-Shucart Type II DAVF in the transverse-sigmoid sinus. Recognition of this route of access, if present, may facilitate endovascular treatment of these lesions. Access to the transverse sinus via this approach can be straightforward and may be underused.
Rivet
Dennis J
DJ
Department of Neurosurgery, Interventional Neuroradiology Service, Mallinckrodt Institute of Radiology, Washington University, St. Louis, Missouri, USA. dennis.j.rivet@mar.med.navy.mil
Goddard
James K
JK
Rich
Keith M
KM
Derdeyn
Colin P
CP
D002406:Catheterization, Peripheral / Q000379:methods; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D008297:Male; D008416:Mastoid / Q000098:blood supply; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014680:Veins