Dural sinus compartment in dural arteriovenous shunts: a new angioarchitectural feature allowing superselective transvenous dural sinus occlusion treatment.
Dural sinus compartment in dural arteriovenous shunts: a new angioarchitectural feature allowing superselective transvenous dural sinus occlusion treatment.
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硬脑膜动静脉分流术中的硬脑膜窦室：一种新的血管结构特征，允许超选择性经静脉硬脑膜窦闭塞治疗。
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
S. S. Lima
中科院分区：
文献类型：
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作者：
R. Piske;C. Campos;J. B. L. Chaves;R. Abicalaf;G. Dabus;L. Batista;C. Baccin;S. S. Lima
背景和目的
硬脑膜窦闭塞已被证明是治疗某些硬脑膜动静脉分流(DVS)的有效方法。然而，关于硬脑膜窦闭塞的意义，没有长期的结果可用。疾病是否会停止，或者其他事件是否会晚些时候发生在剩余的鼻窦还不清楚。对病例的仔细分析使我们发现，在某些情况下，分流术只涉及鼻窦的一个部分或一室。在这篇报告中，我们描述了我们在这些病变的治疗中的结果：仅闭塞受累的腔室，同时保留其余窦和血管造影信号的通畅，从而能够诊断出腔室的存在。
方法和结果
从1996年到2002年10月，我们发现了12例DAVS(在40例DAVS新闻病例中)，有两种类型的间隔--一种在窦内，我们称之为“间隔”(9例)，另一种在窦外，我们称之为“副窦”(3例)。9例超选择性完全闭塞病变。其中2例需二次封堵整个鼻窦，1例因无法置管导致鼻窦闭塞。对照组再通2例，分别采用动脉、动静脉联合入路治疗。
结论
在诊断性血管造影中，诊断硬脑膜动静脉分流中是否存在分流室是非常重要的。在大多数情况下，它允许通过仅闭塞腔室而保留鼻窦其余部分的通畅来根治病变。
BACKGROUND AND PURPOSE
The dural sinus occlusion has been shown to be effective in the treatment of some dural arteriovenous shunts (DAVS). No long-term results are available, however, regarding the significance of occlusion of a dural sinus. If the disease will stop or if other events will occur later in the remaining sinuses are not well known yet. Careful analyses of our cases led us to discover that, in some instances, the shunt involves only a single portion or compartment of a sinus. In this report, we describe our results in the treatment of these lesions: occluding only the involved compartment while preserving patency of the remainder of the sinus and the angiographic signals, thus allowing diagnosis of the presence of a compartment.
METHODS AND RESULTS
From 1996 to October 2002, we found 12 cases of DAVS (among 40 news cases of DAVS) with two types of compartments--one inside the sinus, which we call "septation" (nine cases), and the other outside the sinus, which we call "accessory sinus" (three cases). It was possible to occlude completely the lesion superselectively in nine cases. In two cases, it was necessary to occlude the entire sinus secondarily, and in one case the sinus was occluded because was impossible to catheterize the septation. Two cases with recanalization on the control were treated by additional arterial and arterial and venous approach.
CONCLUSION
It is very important to diagnose the presence of a compartment in dural arteriovenous shunts during the diagnostic angiography. In most cases, it allows curative treatment of the lesion by occluding only the compartment while preserving patency of the remainder of the sinus.