title: Endovascular treatment of complex dural arteriovenous fistula using the dual-microcatheter technique.
abstract: A 71-year-old woman presented with headache and dilated vessels on CTA. Angiography demonstrated a complex dural arteriovenous fistula with retrograde cortical venous hypertension, supplied by branches of internal and external carotids bilaterally into a fistulous pouch paralleling the left transverse and sigmoid sinuses, which was occluded at the jugular bulb. The patient refused treatment and was lost to follow-up, returning with sudden confusion and hemianopsia from left temporo-occipital hemorrhage. Transvenous endovascular embolization was performed using the dual-microcatheter technique with a combination of coiling and Onyx copolymer, completely occluding the sinus and fistula while preserving normal venous drainage. The video can be found here: http://youtu.be/u_4Oc7tSmDM .
authors.affiliation: Departments of Neurological Surgery and.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Levitt
authors.forename: Joshua W
authors.initials: JW
authors.lastname: Osbun
authors.forename: John D
authors.initials: JD
authors.lastname: Nerva
authors.forename: Louis J
authors.initials: LJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D020785:Central Nervous System Vascular Malformations / Q000601:surgery*; D002533:Cerebral Angiography; D004121:Dimethyl Sulfoxide; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D011145:Polyvinyls
chemical_list: C450660:Onyx copolymer; D011145:Polyvinyls; D004121:Dimethyl Sulfoxide
keywords: Onyx; arteriovenous fistula; embolization; endovascular; video