前颅窝硬脑膜动静脉瘘的经动脉和经静脉联合栓塞术
Combined transarterial and transvenous embolization of anterior cranial fossa dural arteriovenous fistula.
作者信息
Sugihara Masahiro, Fujita Atsushi, Ikeuchi Yusuke, Hori Tatsuo, Kohta Masaaki, Tanaka Kazuhiro, Kimura Hidehito, Sasayama Takashi
机构信息
Department of Neurosurgery, Kobe University Graduate School of Medicine, Kobe, Japan.
出版信息
Surg Neurol Int. 2023 Aug 4;14:277. doi: 10.25259/SNI_487_2023. eCollection 2023.
BACKGROUND
Excessive glue injection into the drainage vein in patients with dural arteriovenous fistula (dAVF) can result in venous obstruction. We performed transarterial embolization (TAE) combined with transvenous embolization (TVE) with coils to prevent the glue from migrating into the normal cortical veins.
CASE DESCRIPTION
A 57-year-old man was pointed out to have a Borden Type III anterior cranial fossa dAVF during a check-up for putaminal hemorrhage. Because a left frontal normal cortical vein drained into the pathological drainage vein, excessive glue injection into the drainage vein may have caused venous obstruction. We performed TVE with coils at the foot of the draining vein to prevent excessive migration of glue into the drainer, followed by TAE with glue. With this technique, complete obliteration of the shunt without venous ischemia was obtained.
CONCLUSION
The combined treatment of TAE and TVE is effective in preventing venous ischemia caused by unintended migration of glue cast into the drainage vein.
背景
在硬脑膜动静脉瘘（dAVF）患者的引流静脉中过度注入胶水可导致静脉阻塞。我们采用经动脉栓塞术（TAE）联合经静脉栓塞术（TVE）并使用弹簧圈，以防止胶水迁移至正常皮质静脉。
病例描述
一名57岁男性在因壳核出血进行检查时被发现患有前颅窝Borden III型dAVF。由于一条左侧额叶正常皮质静脉汇入病理性引流静脉，向引流静脉中过度注入胶水可能会导致静脉阻塞。我们在引流静脉末端采用弹簧圈进行TVE，以防止胶水过度迁移至引流静脉，随后采用胶水进行TAE。通过该技术，实现了分流的完全闭塞且未出现静脉缺血。
结论
TAE和TVE联合治疗可有效预防因胶水铸型意外迁移至引流静脉而导致的静脉缺血。
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