Selective transvenous liquid embolization of a Type 1 dural arteriovenous fistula at the junction of the transverse and sigmoid sinuses

Case report

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  • 1 Department of Neurosurgery, Mie University School of Medicine, Tsu, Mie, Japan
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✓ The authors describe the case of a 51-year-old man with a Type 1 dural arteriovenous fistula (AVF) located at the junction of the transverse and sigmoid sinuses. The dural AVF developed after the patient underwent a craniotomy for an acute extradural hematoma. The patient suffered pulsatile tinnitus 3 months after surgery. After several attempts at transarterial embolization (TAE), the venous channel located close to the skull fracture was accessed via a transfemoral—transvenous approach and was embolized by administering a liquid nonadhesive agent. Successful embolization of the dural AVF was achieved both clinically and radiologically without causing considerable hemodynamic alterations. This procedure, either alone or combined with TAE, would seem to be an alternative treatment for dural AVFs in this location, without causing compromise of flow within the affected sinuses, when selective venous access is available.

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Contributor Notes

Address reprint requests to: Kazuhiro Ohtakara, M.D., Department of Neurosurgery, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. email: pingouin@nyc.odn.ne.jp.
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