Intracranial and Spinal Dural Arteriovenous Fistulas

Preface
Acknowledgements
About the Book
Contents
About the Editor
1: Classifications of Cranial and Spinal Dural Arteriovenous Fistulas and Their Endovascular Embolization
1.1 Introduction
1.2 Zipfel Classification of  DAVFs [13]
1.3 Endovascular Approaches
1.4 Transarterial Embolization
1.4.1 nBCA
1.4.2 Onyx
1.4.3 PHIL and Squid
1.5 Transvenous Approach
1.6 Stereotactic Radiosurgery
1.7 Surgery
1.8 Endovascular Management Based on Zipfel Classification of DAVFs [13]
1.9 Conclusions
References
2: Pediatric Intracranial Dural Arteriovenous Fistulas: Review of the Literature and Case Report
2.1 Introduction
2.2 Pediatric dAVF Classification
2.2.1 Dural Sinus Malformation
2.2.2 Infantile dAVFs
2.2.3 Adult-Type dAVFs
2.2.4 Other Classifications
2.3 Pathogenesis
2.4 Natural History
2.5 Clinical Manifestations
2.5.1 Symptoms of High-Flow Arteriovenous Shunts
2.5.1.1 Pediatric DSM with dAVF
2.5.1.2 Infantile dAVF
2.5.2 Symptoms from Retrograde Venous Drainage
2.5.3 Symptoms of Cavernous Sinus Involvement
2.5.4 Other Symptoms
2.6 Diagnostics
2.7 Treatment
2.7.1 Endovascular Treatment
2.8 Conclusion
References
3: Pediatric Dural Arteriovenous Shunts
3.1 Introduction
3.2 Classification and Description of Arteriovenous Shunts
3.3 Angiographic characteristics
3.4 Treatment
3.5 Predictors of Poor Neurological Outcome
3.6 Dural Sinus Malformations
3.7 Infantile Dural Arteriovenous Shunts
3.8 Adult-Type Dural Arteriovenous Shunts
3.9 Conclusion
References
4: A Small Tentorial Dural Arteriovenous Fistula with a Venous Aneurysm in the Pons Mimicking a Cavernous Angioma
4.1 Introduction
4.2 Case Presentation
4.3 Discussion
4.4 Conclusion
References
5: Endovascular Treatment for Traumatic Internal Carotid Cavernous Fistula: Current Difficulties and Solutions
5.1 Introduction
5.2 Angioarchitecture of TICCF
5.2.1 Feeding Artery
5.2.2 CS State and Fistula
5.2.3 Draining Path
5.2.4 Relationship Between Symptoms and Venous Drainage
5.3 EVT Principle and Choices
5.4 Transarterial EVT Technique
5.4.1 Reconstructive with Detachable Balloon or Coils
5.4.2 Reconstructive with Covered Stent and FD
5.4.2.1 Covered Stent
5.4.2.2 Flow Diversion
5.4.3 Deconstruction with ICA Trapping
5.5 Transvenous or Combined Transarterial EVT Techniques
5.6 Special Types of TICCF
5.6.1 Bilateral TICCFs
5.6.2 Recurrent TICCF
5.7 Complications
5.7.1 Technique Complication
5.7.2 Cranial Nerve Palsy
5.7.3 Ischemic Complication
5.7.4 Trigeminocardiac Reflex
5.8 Prognosis
5.9 Summary
References
6: Angioarchitecture of Dural Arteriovenous Fistula
6.1 Introduction
6.2 Understanding dAVF Angioarchitecture from a Pathogenetic Point of View
6.2.1 The Dural Venous Sinus “Compartment” as the Site of the Fistula
6.2.2 Parallel Venous Channel
6.2.3 The Common Arterial Collector
6.3 Classification Schemes That Detail Venous Aspects of the Angioarchitecture of dAVF
6.4 Location-Specific Angioarchitecture
6.5 Summary
References
7: The Clinical Value of SWI in Dural Arteriovenous Fistula: Detection of Extensive Parenchymal Pathology
7.1 Case Report
7.2 Discussion
7.3 Conclusion
References
8: Transvenous Embolization of Dural Arteriovenous Fistulas
8.1 Introduction
8.2 Transvenous Methods
8.3 Selection of Embolic Materials
8.4 Carotid-Cavernous Fistulas (CCFs)
8.5 Transverse-Sigmoid Sinus DAVFs
8.6 Tentorial DAVFs
8.7 Superior Sagittal Sinus DAVFs
8.8 Anterior Cranial Fossa DAVFs
8.9 Other DAVFs
8.10 Conclusions
References
9: Dural Carotid-Cavernous Fistula Treatment
9.1 Introduction
9.2 Cavernous Sinus Anatomy
9.3 Arterial Supply to a dCCF
9.4 Endovascular Treatment of a dCCF
9.5 Transvenous Access
9.5.1 Inferior Petrosal Sinus Approach
9.5.1.1 Ipsilateral IPS Approach
9.5.1.2 Contralateral IPS Approach
9.5.1.3 Approach for Bilateral Dural CCFs
9.5.2 Facial Vein Approach
9.5.3 Superficial and Middle Temporal Vein Approach
9.5.4 Superior Petrosal Sinus (SPS) Approach
9.5.5 Direct SOV Puncture
9.5.6 Transarterial Access
9.5.7 Open Surgery
9.6 Complications of Endovascular Embolization
9.7 Conclusion
References
10: Cavernous Dural Arteriovenous Fistulas: Transorbital Cavernous Sinus Direct Puncture
10.1 Introduction
10.2 Anatomy
10.2.1 Venous Connections
10.2.2 Cranial Nerves, Optic Canal and Orbital Fissures
10.3 Classification
10.4 Clinical Manifestations
10.5 Diagnosis
10.6 Treatment
10.6.1 Treatment Options
10.6.2 Endovascular Treatment: Results and Limitations
10.6.3 Alternative Approaches
10.6.4 Cavernous Sinus Direct Puncture: Technique
10.6.4.1 Inferolateral Access
10.6.4.2 Superomedial Access
10.7 Conclusion
References
11: Cranial Dural Arteriovenous Fistulas: The Role of Transarterial and Transvenous Balloon-Assisted Embolization
11.1 Introduction
11.2 Pros and Cons of Transarterial and Transvenous Approaches
11.2.1 Transarterial Approach
11.2.2 Transvenous Approach
11.3 Dural Sinus Sacrifice Versus Dural Sinus Preservation
11.4 Specific Challenges While Treating DAVFs
11.4.1 DAVFs with Direct Leptomeningeal Venous Drainage
11.4.2 DAVFs Draining to a Dural Sinus
11.5 Rationale for the Use of Balloon Catheters in DAVF Treatment
11.5.1 Transarterial Double-Lumen Balloon
11.5.2 Transvenous “Protective” Balloon
11.6 Technical Nuances for the Use of Transarterial and Transvenous Balloon Catheters
11.6.1 DAVFs with Direct Leptomeningeal Venous Drainage
11.6.2 DAVFs Draining to a Dural Sinus
11.7 Results of the Balloon-Assisted Treatment of DAVFs
11.7.1 Transarterial Double-Lumen Balloon Catheter
11.7.2 Transvenous “Protection” Balloon Catheter
11.8 Perspectives
11.9 Conclusion
References
12: Tentorial Dural Arteriovenous Fistulas: Anatomy, Clinical Presentation and Endovascular Treatment
12.1 Introduction
12.2 Epidemiology
12.3 Anatomical Considerations
12.4 Vascular Supply
12.5 Venous Drainage
12.6 Clinical Presentation
12.7 Classification
12.8 Treatment
12.8.1 Microsurgical Treatment
12.8.2 Endovascular Treatment
12.8.2.1 Transvenous Approach
12.8.2.2 Transarterial Approach
12.8.3 Endovascular Treatment Results
12.8.4 Importance of the Preferential Use of the Middle Meningeal Artery
12.8.5 Middle Meningeal Artery Limitations
12.8.6 Use of an Alternative Arterial Access
12.8.7 Transvenous and Combined Approaches
12.8.8 Nonadhesive Liquids as the Preferred Embolic Agent
12.8.9 Influence of the Number of Arterial Feeders
12.8.10 Clinical Outcomes
12.8.11 Complications
12.8.12 Cranial Nerve Deficits After Arterial Embolization
12.8.13 Middle Meningeal Artery
12.8.14 Medial Tentorial Artery
12.8.15 Distal Onyx Migration
12.8.16 Hemorrhage
12.9 Conclusions
References
13: Structural Analysis of Tentorial Dural Arteriovenous Fistulae with Special Considerations of Venous Ectasia: Proposing a Simpler Classification
13.1 Introduction
13.2 Clinical Presentations
13.3 Summary of Previously Reported Classifications: Anatomy of a Tentorium Cerebelli and TdAVF
13.4 Our Data
13.4.1 Materials and Methods
13.4.2 Results
13.4.3 Case Presentations
13.4.4 Discussion
13.5 The BVs and the EVs
13.5.1 BV
13.5.2 BV Related to TdAVF
13.5.2.1 Superior Tentorial BVs
13.5.2.2 Petrosal BVs or Anterior Metencephalic Group
13.5.2.3 Falcine BVs
13.5.2.4 Galenic or Superior Group of the Posterior Fossa
13.5.2.5 Inferior Tentorial BVs or Dorsal Metencephalic Group
13.5.3 EVs
13.6 Concept of “Directness, Exclusiveness, and Strain” [65]
13.6.1 General Considerations
13.7 Conclusions
13.7.1 Locations of the Shunt of TdAVF
References
14: Dural Arteriovenous Fistula in Moyamoya Angiopathy
14.1 Introduction
14.2 Pathophysiology
14.3 Management
14.4 Conclusion
References
15: Spinal Dural Arteriovenous Shunts
15.1 Introduction
15.2 Classification of the SDAVSs (Fig. 15.1, Tables 15.1 and 15.2) [1, 2]
15.3 Natural History and Age Onset, Clinical Presentation Corresponding to Each Type of Classification [2, 6, 12]
15.3.1 Spinal SDAVS
15.3.2 Pathology: Clinical Presentation
15.3.3 SDAVS: Pathophysiology
15.4 Treatment Options: Need Full Information from Imaging Findings
15.4.1 SDAVS: Treatment Indications [6, 8, 11]
15.4.2 SDAVS: Endovascular Treatment [1, 3, 6, 8, 13]
15.4.3 SDAVS: Treatment Surgery
15.5 Imaging of Spinal DAVS
15.5.1 MRI Imaging of Spinal DAVS (Fig. 15.3) [1, 6–8]
15.5.2 Current Imaging Protocol [1, 4, 6, 7, 9, 14, 15]
15.5.3 Special Consideration in Pediatric Spinal Arteriovenous Shunts
15.5.4 Differential Diagnosis
15.5.4.1 Spinal Dural Arteriovenous Shunts
15.6 Spinal Vascular Anatomy and Imaging (Figs. 15.20, 15.21 and 15.22) [1, 4, 7, 9, 15]
15.6.1 Routine Protocol in the Work-Up of the Spinal AV Shunt in the Spinal Angiogram (Figs. 15.23, 15.24, 15.25, 15.26 and 15.27)
15.6.2 Technique: ±Under GA
15.7 Follow Up Imaging of Spinal Vascular Lesions
15.7.1 Recurrence Symptoms After Endovascular Treatment
References
16: Intraoperative Imaging Techniques in the Surgical Management of Spinal AV Fistulas
16.1 Introduction, Diagnosis and Treatment
16.1.1 Introduction
16.1.2 Diagnosis
16.1.3 Treatment
16.2 Intraoperative Imaging Techniques
16.2.1 Indocyanine Green Videoangiography (ICGVA)
16.2.2 Intraoperative Ultrasound (ioUS)
16.2.3 Sodium Fluorescein
16.3 Conclusions
References
17: Embolization of Spinal Dural Arteriovenous Fistulae Using a Nonadhesive Liquid Embolic Agent Delivered Via a Dual-Lumen Balloon Catheter
17.1 Spinal Vascular Anatomy
17.2 Pathophysiology
17.3 Diagnostic Angiography
17.4 Management
17.5 NLEAs
17.6 Dual-Lumen Balloon Catheters
17.7 Embolization Using a Dual-Lumen Balloon
17.8 Dual-Lumen Balloon Catheter Use to Treat an SDAVF
17.9 Follow-Up
17.10 Conclusion
References
18: Predicting Outcomes of Stereotactic Radiosurgery for Dural Arteriovenous Fistulas
18.1 Chapter Overview
18.2 Current Grading Scales
18.3 Predictors of Obliteration
18.3.1 Anatomy
18.3.2 Physiology
18.3.3 Clinical Characteristics
18.4 Predictors of Adverse Events
18.4.1 Anatomy
18.4.2 Physiology
18.4.3 Clinical Characteristics
18.5 Next Steps
References
19: Complications During Endovascular Embolization of Dural Arteriovenous Fistulas
19.1 Introduction
19.2 Trigeminal Cardiac Reflex
19.3 Cranial Nerves Palsy
19.4 Cerebral Infarction
19.5 Venous Infarction and Venous Bleeding
19.6 Vessel Perforation
19.7 Cardiac and Pulmonary Embolism
19.8 Retained Microcatheter
19.9 Intracranial Abscess
19.10 Conclusion
References
20: Hemorrhagic Complications After Endovascular Treatment for Intracranial Dural Arteriovenous Fistulas
20.1 Introduction
20.2 Classification of EVT-Associated Hemorrhage
20.3 Angioarchitecture of EVT-Associated Hemorrhage
20.3.1 Feeding Artery
20.3.2 Fistula Structure
20.3.3 Draining Vein
20.4 EVT Techniques, Risks, and Preventive Measures
20.4.1 General Considerations
20.4.2 TAE, Risks and Preventive Measures
20.4.3 TVE, Its Risks, and Preventive Measures
20.4.3.1 Sinus Trapping
20.4.3.2 Sinus Preservation by Retrograde Catheterization
20.4.4 Combination of TAE and TVE with Balloon Protection
20.5 Treatment and Prognosis of Hemorrhagic Complications
20.6 Summary
References