Concepts of combined endovascular and surgical treatment for dural arteriovenous fistulae: concepts derived from experience in treating three unusual lesions

被引:9
作者
Rath, SA [1 ]
Derakshani, S [1 ]
机构
[1] Klinikum Deggendorf, Dept Neurosurg & Intervent Neuroradiol, D-94469 Deggendorf, Germany
关键词
arterial occlusion; dural arteriovenous malformation; embolization; venous occlusion;
D O I
10.1007/s00701-003-0147-6
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background. We describe a treatment protocol for patients who have a dural arteriovenous fistulae (dAVF) not curable solely by an endovascular approach. Material and methods. Three patients suffering from neurological impairment due to a complex dAVM (intracranial haemorrhage 2, intracranial hypertension 1) were treated by a combination of arterial embolization treatment and subsequent surgery. Results. Marked reduction of flow was achieved by embolization of the main arterial feeders of the fistulae. Surgery eliminated the residual dAVFs completely and without permanent morbidity. Conclusion. It is necessary to eliminate a dural fistula completely, especially in a patient whose fistula had drainage or reflux into cortical veins, which have a high risk of intracranial haemorrhage and venous hypertension. We present an approach to treatment using transarterial embolization and early surgery which may offer a safe and effective way to achieve complete elimination of the lesion, avoiding increased risk to important venous drainage.
引用
收藏
页码:229 / 235
页数:7
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