Transfemoral Transvenous Embolization of Dural Arteriovenous Fistulas Involving the Isolated Transverse-Sigmoid Sinus

摘要

Dural arteriovenous fistulas involving the transverse-sigmoid sinus (T-S dAVFs) are sometimes isolated because this affected sinus is often thrombosed. It is difficult to perform to micro-catheter cannulation to the isolated sinus through the thrombosed portion. We are now treating these T-S dAVFs by transfemoral transvenous embolization via the ipsilateral side even if the affected sinus is thrombosed and isolated or not. We use a triaxial system (6 Fr. guiding catheter / 4 Fr. diagnostic catheter / micro-catheter) to emphasize the pushability and handling of the microcatheter. And we insert 4 Fr. Catheter into the affected sinus. So we can perform microcatheter cannulation into the isolated and affected sinus for treatment by coil embolization with various detachable coils.