• World Neurosurg · Sep 2018

    Technical Trick of Combined Embolization of Inaccessible Dural Arteriovenous Fistula by Endovascular Route Only.

    • Jonghoon Kim, Chulhoon Chang, and Youngjin Jung.
    • Department of Neurosurgery, Yeungnam University Medical Center and Medical School, Daegu, South Korea.
    • World Neurosurg. 2018 Sep 26.

    ObjectiveEndovascular embolization of dural arteriovenous fistula may not be a feasible approach depending on the location and/or surrounding structures.MethodsCombined embolization comprising endovascular embolization by direct puncture of the sinus after small craniotomy under fluoroscopic guidance is a good treatment option for lesions that cannot be treated by endovascular embolization alone.ResultsWe presented 2 cases of dural arteriovenous fistula that could not be treated by endovascular embolization alone. Treatment included direct puncture of the sinus after small craniotomy to access and completely block the lesion.ConclusionsCombined techniques are required for the management of complex dural arteriovenous fistula. We report a treatment method that can be used for lesions that cannot be treated by endovascular embolization alone along with some technical pitfalls.Copyright © 2018 Elsevier Inc. All rights reserved.

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