Document Detail


Cavernous redirection of venous drainage after partial transvenous coil occlusion of a sigmoid sinus dAVF: coil mass retrieval with flexible cysto-urethroscopy grasping forceps. a technical note.
MedLine Citation:
PMID:  21696659     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We describe the case of a patient who presented with ocular symptoms (chemosis, proptosis, increased intra-ocular pressure, impaired visual acuity) eight months after the transvenous coil occlusion of an ipsilateral sigmoid sinus dural arteriovenous fistula (dAVF). Digital substraction angiography revealed a partial occlusion of the left sigmoid sinus with coils. Since the connection from the sigmoid sinus to the internal jugular vein was obliterated by coils without interrupting the arteriovenous shunt, the venous drainage was redirected into the inferior petrosal sinus, the cavernous sinus and the superior ophthalmic vein. The transjugular access to the inferior petrosal sinus was obstructed by a large coil mass in the jugular bulb. Several attempts to remove these coils with an Alligator retrieval device and a goose neck snare failed. The coil mass was withdrawn via a direct access to the internal jugular vein using flexible cysto-urethroscopy grasping forceps, an urological device designed for the removal of kidney stones. After establishing anterograde drainage, the now accessible inferior petrosal sinus was occluded with fibered coils and the dAVF was completely obliterated. The ocular symptoms resolved within ten days.
Authors:
M Aguilar Pérez; A Kühn; E Miloslavski; H Henkes
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Publication Detail:
Type:  Case Reports; Journal Article; Technical Report     Date:  2011-06-20
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  17     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-23     Completed Date:  2011-09-14     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  203-7     Citation Subset:  IM    
Affiliation:
Department of Neuroradiology, University of Duisburg-Essen, Stuttgart, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Central Nervous System Vascular Malformations / radiography,  therapy*
Cerebral Angiography
Cerebral Veins / radiography
Cranial Sinuses / radiography
Cystoscopes
Device Removal / instrumentation*,  methods*
Embolization, Therapeutic / instrumentation*,  methods*
Female
Humans
Surgical Instruments
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