Division of Interventional Neuroradiology, Department of Diagnostic Radiology, University of Maryland Medical Center, Baltimore, Maryland, USA.
National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA.
J Neurointerv Surg. 2024 Jul 16;16(8):852. doi: 10.1136/jnis-2023-020506.
Cerebral dural arteriovenous fistulas (dAVFs) are commonly treated with endovascular embolization, either through arterial or venous routes in single or multi-staged procedures. Treatment outcomes depend on multiple factors, including the patient's clinical status, the anatomy of the malformation, and the operator's experience, but technical success is also highly dependent on choice of neurovascular devices and embolic agents. When transvenous routes are not feasible and the most obvious transarterial routes do not appear safe, deep knowledge of the dynamic fluid properties of liquid embolics can be a valuable asset. We present a case(video 1) in which a complex skull-base dAVF was completely occluded through a non-visualized previously partially embolized arterial feeder. It is a unique case in which the embolization takes advantage of the peculiar fluid dynamic properties of non-adhesive embolic agents (Onyx-Medtronic, Minnesota, USA) 18 and 34.1-3 neurintsurg;16/8/852/V1F1V1Video 1 Technical video presenting a dAVF completely cured through a non-visible previously embolized arterial pedicle.
颅内硬脑膜动静脉瘘（dAVF）通常采用血管内栓塞治疗，可通过动脉或静脉途径进行单一或多阶段治疗。治疗结果取决于多个因素，包括患者的临床状况、畸形的解剖结构和操作者的经验，但技术成功也高度依赖于神经血管器械和栓塞剂的选择。当静脉途径不可行且最明显的动脉途径看起来不安全时，对液体栓塞剂的动态流体特性的深入了解可能是一项宝贵的资产。我们呈现了一个病例（视频 1），其中一个复杂的颅底 dAVF 通过以前部分栓塞的动脉供体完全闭塞。这是一个独特的病例，栓塞利用了非粘性栓塞剂（美国美敦力公司的 Onyx）的特殊流体动力学特性 18 和 34.1-3 neurintsurg；16/8/852/V1F1V1视频 1 技术视频展示了通过以前栓塞的动脉蒂完全治愈的 dAVF。
