Document Detail

Preoperative or preembolization lesion targeting using rotational angiographic fiducial marking in the neuroendovascular suite.
MedLine Citation:
PMID:  20170306     Owner:  NLM     Status:  MEDLINE    
Three-dimensional rotational digital subtraction (DS) angiography and DynaCT allow precise localization of intracranial arteriovenous fistulas (AVFs) with fiducial markers that have helped in surgical planning. These techniques are particularly useful when the AVF is not evident on cross-sectional imaging. The authors demonstrate the utility of 3D DS angiography and DynaCT in the localization of intracranial AVFs in 3 cases. Their first case was a dural AVF with multiple arterial feeders from the left occipital artery that drained into the left transverse sinus. Blood flow to the left transverse sinus was first decreased by embolizing the branch arterial feeders with polyvinyl alcohol particles. Thereafter, 3D DS angiography enabled precise localization of the site for the bur hole creation with a fiducial to allow access for the transverse sinus in the second part of the procedure where definitive transvenous sinus embolization of the dural AVF with coils was performed. They also used 3D DS angiography and DynaCT with fiducials for precise localization of a superficial pial AVF (Case 2) and a tentorial AVF (Case 3) not visible on cross-sectional angiography. With the precise localization of the target lesion, the neurosurgeons were able to perform relatively small craniotomies, minimizing the cranial opening yet allowing the opening for full access to the lesion. By correlating 3D DS angiography/DynaCT with CT images, the neurosurgeon could use neuronavigation in cases of AVF not appreciated on cross-sectional imaging.
Siok Ping Lim; Howard Lesiuk; John Sinclair; Cheemun Lum
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2010-02-19
Journal Detail:
Title:  Journal of neurosurgery     Volume:  114     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-01-03     Completed Date:  2011-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  140-5     Citation Subset:  AIM; IM    
Department of Radiology, The Ottawa Hospital, Ottawa, Ontario, Canada.
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MeSH Terms
Angiography, Digital Subtraction / methods*
Central Nervous System Vascular Malformations / radiography*,  therapy
Cerebral Angiography / methods*
Embolization, Therapeutic
Fiducial Markers*
Middle Aged
Neurosurgical Procedures
Preoperative Care*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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