title: Endovascular treatment of a dural arteriovenous fistula in a patient with Loeys-Dietz syndrome: A case report.
abstract: Background Loeys-Dietz syndrome (LDS) is a recently recognized autosomal dominant connective tissue disease. The manifestations of LDS include vascular tortuosity, scoliosis, craniosynostosis, aneurysm and aortic dissections. Clinical presentation A 35-year-old woman treated with Stanford type B aortic dissection and breast cancer was referred to us for Borden type II dural arteriovenous fistula (dAVF) draining to the vein of Galen, involving the midline of tentorium cerebelli. The dAVF was treated successfully by combined transarterial and transvenous embolization. Because of tortuosity of vertebral arteries, a genetic test was conducted confirming LDS type 2. Conclusions To our knowledge, this is the first case report of dAVF associated with LDS. The relationship between LDS and dAVF is unknown but this report shows the possibility that mutation of transforming growth factor β receptors 2 ( TGFBR2) related to LDS may be related to shunt diseases. Because intervention in LDS seems to be feasible compared to Ehlers Danlos syndrome and Marfan syndrome, it is important to make the correct diagnosis.
authors.affiliation: 1 Tokai University, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Aoki
authors.affiliation: 1 Tokai University, Japan.
authors.forename: Kittipong
authors.initials: K
authors.lastname: Srivatanakul
authors.affiliation: 1 Tokai University, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Osada
authors.affiliation: 1 Tokai University, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Hotta
authors.affiliation: 1 Tokai University, Japan.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Sorimachi
authors.affiliation: 1 Tokai University, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Matsumae
authors.affiliation: 2 Department of Bioscience and Genetics, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan.|3 Department of Medical Genetics, Sakakibara Heart Institute, Tokyo, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Morisaki
mesh_terms: D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D055947:Loeys-Dietz Syndrome / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged
keywords: Loeys-Dietz syndrome; dural arteriovenous fistula; endovascular therapy