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. 1999 Jun 30;5(2):195-8.
doi: 10.1177/159101999900500214. Epub 2001 May 15.

Endovascular Retrograde Cortical Venous Approach to Disconnect Retrograde Leptomeningeal Venous Reflux in a Patient with Dural AVF

M Goyal  1 , K Terbrugge, R Farb
Affiliations

Endovascular Retrograde Cortical Venous Approach to Disconnect Retrograde Leptomeningeal Venous Reflux in a Patient with Dural AVF

M Goyal et al. Interv Neuroradiol. .

Abstract

We report a case of dural arteriovenous fistual (DAVF) with cortical venous reflux in whom disconnection of the refluxing cortical vein was achieved by using a retrograde transcortical venous approach through the cortical vein itself.

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Figures

Figure 1
Figure 1
Non-contrast CT scan shows an intraparenchymal haematoma in the left temporal lobe.
Figure 2
Figure 2
MR venogram using 2D-time-of-flight technique with reconstruction of angiographic projection using MIP algorithm. The left transverse sinus is narrow and irregular (arrows).
Figure 3
Figure 3
Intra-arterial angiogram, left occipital artery injection, lateral view. Multiple small feeders are seen to supply a dural AVF in the wall of the left transverse sinus (arrow). The drainage of the AVF is through a cortical vein (curved open arrow) which finally exits to the suboccipital vein after a circuitous course. Note partially thrombosed transverse sinus (straight open arrow).
Figure 4
Figure 4
Lateral non-subtracted image showing the course of the microcatheter through the vertebral vein and retrogradely through the cortical vein (arrows). The coils were deposited adjacent to the AVF nidus. Note the presence of the arterial catheter in the left occipital artery to serve as a road map.
Figure 5
Figure 5
Post-procedure left external carotid artery injection, lateral view shows complete obliteration of the shunt with absence of cortical venous reflux.
Figure 6
Figure 6
Post-procedure left internal carotid artery injection, lateral view shows patency of the refluxing vein which is now draining the brain parenchyma rather than the AVF (arrows).
See this image and copyright information in PMC

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References

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