Mack W J, Gonzalez N R, Jahan R, Vinuela F
Department of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA.
Interv Neuroradiol. 2011 Mar;17(1):93-103. doi: 10.1177/159101991101700115. Epub 2011 Apr 29.
Dural arteriovenous fistulas (dAVFs) of the anterior cranial fossa have traditionally been treated by open surgical disconnection. Safe navigation through the ophthalmic artery or fragile cortical veins has historically provided a barrier to effective endovascular occlusion of these lesions. Using current microcatheter technology and embolic materials, safe positioning within the distal ophthalmic artery, beyond the origin of the central retinal artery, is achievable. We describe two cases in which anterior cranial fossa dAVFs were treated by exclusively endovascular strategies, and highlight the pertinent technical and anatomic considerations. We discuss the clinical symptoms resulting from the differing venous drainage patterns.
传统上,前颅窝硬脑膜动静脉瘘(dAVF)通过开放性手术切断进行治疗。历史上,安全穿过眼动脉或脆弱的皮质静脉一直是有效血管内闭塞这些病变的障碍。使用当前的微导管技术和栓塞材料,可以在视网膜中央动脉起源之外的眼动脉远端实现安全定位。我们描述了两例仅通过血管内策略治疗前颅窝dAVF的病例,并强调了相关的技术和解剖学考虑因素。我们讨论了不同静脉引流模式导致的临床症状。