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Nuances of transarterial and transvenous embolization of a large tentorial arteriovenous fistula

Nuances of transarterial and transvenous embolization of a large tentorial arteriovenous fistula



Lorenzo Rinaldo, MD, PhD,1 Waleed Brinjikji, MD,1,2 and Leonardo Rangel-Castilla, MD1,2

Departments of 1Neurosurgery and 2Radiology, Mayo Clinic, Rochester, Minnesota

An 80-year-old feminine offered with an extended historical past of extreme pulsatile tinnitus, vertigo, and decreased listening to. She was discovered to have a big right-sided tentorial arteriovenous fistula (AVF) with enlarged deep draining veins, together with the vein of Rosenthal. The affected person underwent Onyx embolization of the fistula through a mixed transarterial and transvenous strategy leading to full obliteration of the fistula. Her signs improved instantly after the process and at 6-months’ follow-up she was clinically asymptomatic with no proof of residual fistula on neuroimaging. Transvenous embolization of AVF is at occasions obligatory when transarterial entry will not be attainable.

Embrace when citing: Printed on-line April 1, 2019; DOI: http://thejns.org/doi/abs/10.3171/2019.4.FocusVid.18674.

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