Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Thammasat University Hospital, Pathum Thani, 12120, Thailand.
Acta Neurochir (Wien). 2024 Mar 12;166(1):131. doi: 10.1007/s00701-024-06020-2.
Transvenous embolization of high-grade dural arteriovenous fistulas (dAVFs) is challenging particularly when the direct sinus access is favorable due to the complex venous anatomy which prohibits endovascular access via the transfemoral approach.
The procedure was conducted in the hybrid operating suite, where a burr hole was performed, followed by direct catheterization of the superior sagittal sinus. Coil embolization was then executed to achieve complete obliteration of the fistula.
The direct puncture of the superior sagittal sinus is a safe and effective method for treating complex dAVFs. This approach grants access to the fistula channel which facilitates curative embolization.
高分级硬脑膜动静脉瘘（dAVF）的经静脉栓塞具有挑战性，尤其是当直接窦内入路是有利的，因为复杂的静脉解剖结构禁止通过经股动脉入路进行血管内治疗。
该手术在杂交手术室进行，在该处进行颅骨钻孔，然后直接对大脑上矢状窦进行导管插入。随后进行线圈栓塞以实现瘘的完全闭塞。
直接穿刺上矢状窦是治疗复杂 dAVF 的一种安全有效的方法。这种方法可以进入瘘管通道，从而促进治愈性栓塞。
