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Focus on the target: Angiographic features of the fistulous point and prognosis of transvenous embolization of cavernous sinus dural arteriovenous fistula

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机构: [1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China [2]Department of neurosurgery, aerospace center hospital, Haidian, Beijing, China [3]Department of Neurosurgery, Puyang People’s Hospital, Henan, China
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关键词: Cavernous sinus dural arteriovenous fistula transvenous embolization prognosis fistulous point angiographic features

摘要:
Background and purpose: Transvenous embolization (NE) is widely utilized as an effective and safe treatment option for cavernous sinus dural arteriovenous fistula (CS-dAVF); however, detecting the exact location of the fistula is challenging. The present study identified the angiographic features of the fistulous point and evaluated the match with the microcatheter tip and fistulous point.& para;& para;Materials and methods: An analysis cohort of 45 consecutive patients with CS-dAVF treated by TVE was analyzed retrospectively. The patients were divided into two groups, 22 matches and 23 mismatches, according to whether the fistulous point and the microcatheter tip were in the same compartment of the cavernous sinus (CS). The angiographic findings, the location of the fistulas, the position of the microcatheter tips, the volume of embolic materials, complications, and outcomes were assessed.& para;& para;Results: Several angiographic features defined the fistulous points, such as the early opacified area, jellyfish-like sign, changes in the density of the contrast medium, the juncture of different arterial supply, enlarged feeders, and hand-injection angiograms. The fistulas were primarily in the posterosuperior portion of the CS (80%) and medial side (73.3%) according to the internal carotid artery. Both groups achieved effective TVE; the matched group required less embolic material than the mismatched group (p= 0.024). The patients with cranial nerve dysfunction (CND) required more embolic materials than others (p=0.032).& para;& para;Conclusion: The fistulous point in most of the CS-dAVFs could be isolated by careful analysis of the angiography images. The matching of the microcatheter tip and fistulous point in the same compartment of CS can reduce the dosage of embolic materials, and a low volume of embolic materials might cause fewer CND complications.

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出版当年[2017]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 核医学
最新[2025]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 核医学
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出版当年[2016]版:
Q4 CLINICAL NEUROLOGY Q4 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
最新[2023]版:
Q3 CLINICAL NEUROLOGY Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China [2]Department of neurosurgery, aerospace center hospital, Haidian, Beijing, China
通讯作者:
通讯机构: [1]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China [*1]Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University Beijing Neurosurgical Institute, No. 6, Tiantan Xili, Dongcheng, Beijing, 100050, P.R. China.
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