Authors: Hyun Seok Choi Dong Ik Kim Byung Moon Kim Dong Joon Kim Sung Soo Ahn
Publish Date: 2011/03/03
Volume: 54, Issue: 2, Pages: 163-169
Abstract
Dural arteriovenous fistulas involving marginal sinus are relatively rare Transvenous embolization is a curative treatment of choice for them Regional anatomy surrounding the marginal sinus comprises complex craniocervical bony structures and abundant venous interconnections Therefore dural arteriovenous fistulas involving marginal sinus may have various routes for a transvenous approach The purpose of this article was to analyze endovascular treatment of marginal sinus dural arteriovenous fistulas with emphasis on the routes of transvenous embolizationFive patients with dural arteriovenous fistulas DAVFs involving the marginal sinus who were treated with transvenous embolization were retrospectively analyzed in terms of endovascular treatment angiographic architecture routes of venous approach and treatment results case by caseThere were no significant complications except for headache ocular pain and facial flushing after transvenous embolization Immediate angiographic outcomes were complete in four patients and partial in one patient Clinical outcomes during followup were complete recovery in four patients and intermittent tinnitus in one patient Three different transvenous approaches were used for transvenous coil embolization ipsilateral internal jugular vein in three patients contralateral internal jugular vein in one patient and vertebral venous plexus in one patientTransvenous coil embolization in treating marginal sinus DAVF is a safe and effective method In case of failure of an internal jugular venous approach alternative routes of embolization should be considered Understanding the regional venous anatomy of the craniocervical junction is important for targeting fistulous sites and selecting routes for transvenous embolization
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