Embolization of dural arteriovenous fistula of anterior cranial fossa via sphenopalatine artery:a effect analysis / 中国脑血管病杂志

ABSTRACT

Objective To preliminarily discuss the safety and effectiveness of embolization of dural arteriovenous fistula of anterior cranial fossa via sphenopalatine artery. Methods From January 2002 to June 2017,the clinical data of 7 patients with dural arteriovenous fistula of anterior cranial fossa embolized via sphenopalatine artery at Department of Neurosurgery,Xuanwu Hospital,Capital Medical University were analyzed retrospectively.There were 6 men and 1 woman,their mean age was 60.4 ± 3.6 years.One patient had subarachnoid hemorrhage with hematoma,6 had non-specific symptoms. The technical methods and complications via sphenopalatine artery embolization were analyzed.The occlusion of the proximal drainage vein with the embolization agent was used as the standard for successful embolization.They were all clinically followed up at 6 months after procedure. Results (1)Five patients selected sphenopalatine artery as the preferred treatment.After embolization failed in other treatment approaches,2 patients were re-embolized via sphenopalatine artery. Five lesions were successfully embolized via sphenopalatine artery,including the sphenopalatine artery as the preferred treatment approach in 4 cases,the sphenopalatine artery as a remedial embolization approach after the failure of other arterial approaches in 1 case.Transsphenoidal artery failed to occlude the lesions in 2 cases,including successful embolization of other blood supply artery in 1 case during the operation,and postoperative angiography revealed that the lesion was almost completely occluded in the other 1.All patients recovered well without complications after procedure.(2)All patients were followed up for 6 months after procedure.The patients did not have blurred vision and other new neurological disorders, and they did not have new intracranial hemorrhage and nasal symptoms.Two of them underwent angiographic follow-up at admission.The immediate angiography in 1 patient showed that his lesion completely disappeared,At 6 months after operation,angiography revealed that the lesion was recurrence-free. The immediate angiography in 1 patient showed that his lesion nearly completely disappeared.At 4 months after operation, angiography revealed that the lesion disappeared completely. Conclusions Embolization of dural arteriovenous fistulas of anterior cranial fossa via sphenopalatine artery is a feasible,safe and effective treatment. It is also the treatment option after other poor arterial approach or failure of other arterial approach.