title: Transvenous approach to intracranial dural arteriovenous fistula (Cognard v): a treatment option. A case report.
abstract: The endovascular technique is the gold standard treatment in dural arteriovenous fistulas. Due to the limited number of series published it is difficult to create rigid guidelines in terms of the best endovascular treatment approach. Treatment must be tailored to each particular case, but it is important to keep in mind that the possibility of treating a type V dAVF by the transvenous approach should not be discarded. In selected cases the transvenous approach may be helpful to increase the chance of success in the endovascular treatment of type V dAVF. We describe a patient in whom the first arterial treatment failed to achieve occlusion of the fistulous point with the glue. Clinical symptoms improved due to the diminished flow at the fistula after the first embolization but as soon as collateral arteries were recruited by the fistula, spinal cord venous drainage impairment led to symptoms recurrence. Transvenous access allowed us to close the fistula completely in one only session with a complete disappearance of the pathologically inverted perimedullary venous flow.
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. saixut@yahoo.es
authors.forename: S
authors.initials: S
authors.lastname: Aixut Lorenzo
authors.forename: S
authors.initials: S
authors.lastname: Aiuxut Lorenzo
authors.forename: A
authors.initials: A
authors.lastname: Tomasello Weitz
authors.forename: J
authors.initials: J
authors.lastname: Blasco Andaluz
authors.forename: L
authors.initials: L
authors.lastname: Sanroman Manzanera
authors.forename: J M
authors.initials: JM
authors.lastname: Macho Fernández
mesh_terms: D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008526:Medulla Oblongata / Q000098:blood supply / Q000000981:diagnostic imaging; D019233:Retreatment; D014014:Tissue Adhesives / Q000627:therapeutic use*
chemical_list: D014014:Tissue Adhesives