Direct Puncture of the Superficial Temporal Artery for EVOH Embolization of a Type 3 Arteriovenous Fistula with a Dual Lumen Balloon
Résumé
Intracranial dural arteriovenous fistulas (dAVFs) may be difficult to treat by endovascular means, especially when the arterial feeders to the fistula are tortuous. 1 The usual main feeder to intracranial dAVFs is the middle meningeal artery, which may present very tight loops that are often difficult to cross with a microcatheter. 2 Direct puncture of a subcutaneous artery feeding the fistula indirectly via transosseous branches may be a valuable strategic option to overcome this limitation. 3 4 We report here the successful embolization of a Cognard type 3 parietal dAVF by direct puncture of the superficial temporal artery under roadmap guidance. The dAVF was subsequently embolized with ethylene vinyl alcohol via a dual lumen balloon, under balloon inflation. We highlight in this technical video 1 the potential difficulties and risks of direct puncture of the superficial temporal artery. We also stress the risk of delayed scalp necrosis using this technique. Video 1.
Fichier principal
Clarençon et al. - 2021 - Direct puncture of the superficial temporal artery.pdf (150.56 Ko)
Télécharger le fichier
Origine | Fichiers produits par l'(les) auteur(s) |
---|