Kishore Kislay, Bodani Vivek, Olatunji Richard, Gao MingYang Meah, Pai Vivek, Marotta Thomas, Spears Julian, Mendes Pereira Vitor
Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Division of Neurosurgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Interv Neuroradiol. 2025 Feb;31(1):128-131. doi: 10.1177/15910199221121370. Epub 2022 Aug 17.
Developmental venous anomaly (DVA) is one of the commonest vascular malformations in the brain but rarely symptomatic. Various pathomechanisms such as mechanical compression, increased in-flow into DVA or outflow obstruction have been described as causative factors in symptomatic DVAs. We report a unique case of a pontomedullary DVA with venous outflow obstruction causing progressive neurological worsening in a young adult despite anticoagulation, who was treated with a novel approach of venous outlet stenting of the collector vein with favorable outcome. In carefully selected cases, this endovascular treatment can be an effective and safe alternative when other measures fail.
发育性静脉异常(DVA)是脑部最常见的血管畸形之一,但很少出现症状。各种病理机制,如机械压迫、流入DVA的血流量增加或流出道梗阻,已被描述为有症状DVA的致病因素。我们报告了一例独特的桥延髓DVA病例,尽管进行了抗凝治疗,但静脉流出道梗阻仍导致一名年轻成年人的神经功能逐渐恶化,该患者采用了一种新的治疗方法,即对引流静脉进行静脉出口支架置入术,取得了良好的效果。在精心挑选的病例中,当其他措施无效时,这种血管内治疗可以是一种有效且安全的替代方法。