Shigeki Ono    Department   Kawasaki Medical School  Kawasaki Medical School, Department of Neurosurgery 2,    Position   Professor
Article types	原著
Language	English
Peer review	Peer reviewed
Title	Triple-catheter Technique in the Transvenous Coil Embolization of Isolated Dural Arteriovenous Fistula.
Journal	Formal name：Neurosurgery ISSN code：0148396X/15244040
Volume, Issue, Page	61(3 Suppl),pp.81-85
Author and coauthor	Sugiu K, Tokunaga K, Nishida A, Sasahara W, Watanabe K, Ono S, Onoda K, Date I.
Publication date	2007/09
Summary	OBJECTIVE: Dural arteriovenous fistulae involving the transverse-sigmoid sinus, which is occluded at its proximal and distal ends (i.e., an isolated sinus), carry a high risk of intracranial hemorrhage or progressive neurological deficits. Although transvenous coil embolization is a useful and safe treatment for such lesions, it is often difficult to reach into the isolated sinus through the occluded sinus using the percutaneous catheter approach. METHODS: We report the successful treatment of two patients with transverse-sigmoid dural arteriovenous fistulae with isolated sinus using the percutaneous transvenous triple-catheter technique. A 6-French guiding catheter was placed at the internal jugular vein followed by a second 4-French catheter positioned at the end of the occluded sinus. A third microcatheter was then navigated into the isolated sinus with support of the second catheter. RESULTS: Although initial attempts to reach into the isolated sinus without the second catheter failed, insertion of the second catheter resulted in successful navigation of the third microcatheter into the affected sinus in both cases. Complete cure was obtained in both cases by coil packing of the affected sinus. CONCLUSION: Although careful maneuvering is required, this triple-catheter technique is useful for treatment of dural arteriovenous fistulae with isolated sinus.
Document No.	17876236