title: [Hybrid surgery for complex symptomatic intracranial fistulas: a technical note].
abstract: Objective:To explore the efficacy of hybrid management of complex symptomatic intracranial fistulas in neurovascular hybrid operating room.Methods:From March 2014 to January 2015, 2 complex dural arteriovenous fistulas and 1 carotid cavernous fistulas were managed by hybrid surgeries in the PLA Rocket Force General Hospital.With first attempts with endovascular treatment failed, all cases were finally managed by hybrid surgery.Dural arteriovenous fistulas were approached via meningeal artery followed craniotomy.The carotid cavernous fistulas were treated by direct puncture into the left cavernous sinus after craniotomy.Results:Post-operative angiography demonstrated complete occlusion for 2 cases and nearly complete occlusion for 1 case.All 3 cases had no complications.On discharge 2 patients presented no symptoms and 1 greatly improved.Within the follow-up (1-33 months), 1 patient had recurrence after 21 months and received re-embolization with complete occlusion.Conclusion:Hybrid surgery is a promising method to manage complex intracranial fistulas.
authors.affiliation: Department of Neurovascular Surgery, New Era Stroke Care & Research Center, PLA Rocket Force General Hospital, Beijing 100088, China.
authors.forename: Y Q
authors.initials: YQ
authors.lastname: Zhang
authors.forename: H C
authors.initials: HC
authors.lastname: Qiu
authors.forename: Y F
authors.initials: YF
authors.lastname: Tao
authors.forename: M L
authors.initials: ML
authors.lastname: Liu
authors.forename: X
authors.initials: X
authors.lastname: Ye
authors.forename: X L
authors.initials: XL
authors.lastname: Chen
authors.forename: W J
authors.initials: WJ
authors.lastname: Jiang
mesh_terms: D002426:Cavernous Sinus; D020785:Central Nervous System Vascular Malformations; D002533:Cerebral Angiography; D003399:Craniotomy; D004621:Embolization, Therapeutic; D006801:Humans; D011677:Punctures; D016157:Vascular Fistula
keywords: Carotid cavernous sinus fistulas; Complex lesions; Dural arteriovenous fistulas; Hybrid surgery