Subocclusive transvenous approach of dural arteriovenous fistula.
Autor(a) principal: | |
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Data de Publicação: | 2011 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528 |
Resumo: | Dural arteriovenous fistulae (DAVF) are usually acquired and when presented with cortical venous drainage are associated with high risk of hemorrhage. They can be treated by arterial or venous embolization, by surgery or by the combination of both techniques. Transvenous approach induces venous sinus thrombosis increasing the risk of venous stroke and/or hemorrhage.Review of all the cases of transvenous embolization of lateral sinus arteriovenous fistulas treated in our department. Our main objective is to evaluate the clinical/imaging results of this treatment and the second goal is to discuss possible advantages of the subocclusive approach in the first session of transvenous treatment.The authors present six clinical cases of DAVF with the following clinical symptoms: visual disturbances (3); ear pulsatile bruit (3); headaches (2); subarachnoid hemorrhage (1); subjective hearing loss (1); optic disc edema (1); hemiparesis (1). Angiographic classification was: Cognard IIa, (3), IIab (2) e IV (1), all of the lateral sinus. The main afferent branches arised from: ipsilateral ECA (6); ipsilateral ICA (6); ipsilateral VA (6); contralateral ECA (5); contralateral VA (5); contralateral ICA (3); ipsilateral PCA (1). Transarterial approach was the first approach in all patients with satisfactory but transient results. It was always followed by transvenous embolization of the lateral sinus with GDC coils. Subocclusive approach was achieved in five patients with the persistence of some afferent arteries. Follow-up angiography in four of them showed "spontaneous" thrombosis of the lateral sinus with clinical and angiographic cure. Thrombosis occurred once during the initial transvenous procedure. There were no complications or new neurological signs or symptoms in any patient.Transvenous treatment of DAVF has led to technical and clinical success without procedure complications. We think that subocclusive approach of the venous sinus with coils can cause less hemodynamic changes with a slower thrombosis rate and less complications, unchanging the angiographic and clinical resolution. |
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Subocclusive transvenous approach of dural arteriovenous fistula.Tratamento suboclusivo por via transvenosa de fístulas arteriovenosas durais.Dural arteriovenous fistulae (DAVF) are usually acquired and when presented with cortical venous drainage are associated with high risk of hemorrhage. They can be treated by arterial or venous embolization, by surgery or by the combination of both techniques. Transvenous approach induces venous sinus thrombosis increasing the risk of venous stroke and/or hemorrhage.Review of all the cases of transvenous embolization of lateral sinus arteriovenous fistulas treated in our department. Our main objective is to evaluate the clinical/imaging results of this treatment and the second goal is to discuss possible advantages of the subocclusive approach in the first session of transvenous treatment.The authors present six clinical cases of DAVF with the following clinical symptoms: visual disturbances (3); ear pulsatile bruit (3); headaches (2); subarachnoid hemorrhage (1); subjective hearing loss (1); optic disc edema (1); hemiparesis (1). Angiographic classification was: Cognard IIa, (3), IIab (2) e IV (1), all of the lateral sinus. The main afferent branches arised from: ipsilateral ECA (6); ipsilateral ICA (6); ipsilateral VA (6); contralateral ECA (5); contralateral VA (5); contralateral ICA (3); ipsilateral PCA (1). Transarterial approach was the first approach in all patients with satisfactory but transient results. It was always followed by transvenous embolization of the lateral sinus with GDC coils. Subocclusive approach was achieved in five patients with the persistence of some afferent arteries. Follow-up angiography in four of them showed "spontaneous" thrombosis of the lateral sinus with clinical and angiographic cure. Thrombosis occurred once during the initial transvenous procedure. There were no complications or new neurological signs or symptoms in any patient.Transvenous treatment of DAVF has led to technical and clinical success without procedure complications. We think that subocclusive approach of the venous sinus with coils can cause less hemodynamic changes with a slower thrombosis rate and less complications, unchanging the angiographic and clinical resolution.Dural arteriovenous fistulae (DAVF) are usually acquired and when presented with cortical venous drainage are associated with high risk of hemorrhage. They can be treated by arterial or venous embolization, by surgery or by the combination of both techniques. Transvenous approach induces venous sinus thrombosis increasing the risk of venous stroke and/or hemorrhage.Review of all the cases of transvenous embolization of lateral sinus arteriovenous fistulas treated in our department. Our main objective is to evaluate the clinical/imaging results of this treatment and the second goal is to discuss possible advantages of the subocclusive approach in the first session of transvenous treatment.The authors present six clinical cases of DAVF with the following clinical symptoms: visual disturbances (3); ear pulsatile bruit (3); headaches (2); subarachnoid hemorrhage (1); subjective hearing loss (1); optic disc edema (1); hemiparesis (1). Angiographic classification was: Cognard IIa, (3), IIab (2) e IV (1), all of the lateral sinus. The main afferent branches arised from: ipsilateral ECA (6); ipsilateral ICA (6); ipsilateral VA (6); contralateral ECA (5); contralateral VA (5); contralateral ICA (3); ipsilateral PCA (1). Transarterial approach was the first approach in all patients with satisfactory but transient results. It was always followed by transvenous embolization of the lateral sinus with GDC coils. Subocclusive approach was achieved in five patients with the persistence of some afferent arteries. Follow-up angiography in four of them showed "spontaneous" thrombosis of the lateral sinus with clinical and angiographic cure. Thrombosis occurred once during the initial transvenous procedure. There were no complications or new neurological signs or symptoms in any patient.Transvenous treatment of DAVF has led to technical and clinical success without procedure complications. We think that subocclusive approach of the venous sinus with coils can cause less hemodynamic changes with a slower thrombosis rate and less complications, unchanging the angiographic and clinical resolution.Ordem dos Médicos2011-12-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528oai:ojs.www.actamedicaportuguesa.com:article/1528Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 2; 51-58Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 2; 51-581646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528/1113Pinto, Pedro SoaresMoreira, BrunoAlves, ViriatoCaixeiro, TeresaStocker, AlfredoCruz, RomeuXavier, Joãoinfo:eu-repo/semantics/openAccess2022-12-20T10:58:02Zoai:ojs.www.actamedicaportuguesa.com:article/1528Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:12.583848Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Subocclusive transvenous approach of dural arteriovenous fistula. Tratamento suboclusivo por via transvenosa de fístulas arteriovenosas durais. |
title |
Subocclusive transvenous approach of dural arteriovenous fistula. |
spellingShingle |
Subocclusive transvenous approach of dural arteriovenous fistula. Pinto, Pedro Soares |
title_short |
Subocclusive transvenous approach of dural arteriovenous fistula. |
title_full |
Subocclusive transvenous approach of dural arteriovenous fistula. |
title_fullStr |
Subocclusive transvenous approach of dural arteriovenous fistula. |
title_full_unstemmed |
Subocclusive transvenous approach of dural arteriovenous fistula. |
title_sort |
Subocclusive transvenous approach of dural arteriovenous fistula. |
author |
Pinto, Pedro Soares |
author_facet |
Pinto, Pedro Soares Moreira, Bruno Alves, Viriato Caixeiro, Teresa Stocker, Alfredo Cruz, Romeu Xavier, João |
author_role |
author |
author2 |
Moreira, Bruno Alves, Viriato Caixeiro, Teresa Stocker, Alfredo Cruz, Romeu Xavier, João |
author2_role |
author author author author author author |
dc.contributor.author.fl_str_mv |
Pinto, Pedro Soares Moreira, Bruno Alves, Viriato Caixeiro, Teresa Stocker, Alfredo Cruz, Romeu Xavier, João |
description |
Dural arteriovenous fistulae (DAVF) are usually acquired and when presented with cortical venous drainage are associated with high risk of hemorrhage. They can be treated by arterial or venous embolization, by surgery or by the combination of both techniques. Transvenous approach induces venous sinus thrombosis increasing the risk of venous stroke and/or hemorrhage.Review of all the cases of transvenous embolization of lateral sinus arteriovenous fistulas treated in our department. Our main objective is to evaluate the clinical/imaging results of this treatment and the second goal is to discuss possible advantages of the subocclusive approach in the first session of transvenous treatment.The authors present six clinical cases of DAVF with the following clinical symptoms: visual disturbances (3); ear pulsatile bruit (3); headaches (2); subarachnoid hemorrhage (1); subjective hearing loss (1); optic disc edema (1); hemiparesis (1). Angiographic classification was: Cognard IIa, (3), IIab (2) e IV (1), all of the lateral sinus. The main afferent branches arised from: ipsilateral ECA (6); ipsilateral ICA (6); ipsilateral VA (6); contralateral ECA (5); contralateral VA (5); contralateral ICA (3); ipsilateral PCA (1). Transarterial approach was the first approach in all patients with satisfactory but transient results. It was always followed by transvenous embolization of the lateral sinus with GDC coils. Subocclusive approach was achieved in five patients with the persistence of some afferent arteries. Follow-up angiography in four of them showed "spontaneous" thrombosis of the lateral sinus with clinical and angiographic cure. Thrombosis occurred once during the initial transvenous procedure. There were no complications or new neurological signs or symptoms in any patient.Transvenous treatment of DAVF has led to technical and clinical success without procedure complications. We think that subocclusive approach of the venous sinus with coils can cause less hemodynamic changes with a slower thrombosis rate and less complications, unchanging the angiographic and clinical resolution. |
publishDate |
2011 |
dc.date.none.fl_str_mv |
2011-12-29 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528 oai:ojs.www.actamedicaportuguesa.com:article/1528 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528 |
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oai:ojs.www.actamedicaportuguesa.com:article/1528 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/1528/1113 |
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openAccess |
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Ordem dos Médicos |
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Ordem dos Médicos |
dc.source.none.fl_str_mv |
Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 2; 51-58 Acta Médica Portuguesa; Vol. 24 (2011): Suplemento 2; 51-58 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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