Treatment of dural arteriovenous fistula around the anterior condylar confluent -simultaneous treatment with endovascular techniques and gamma knife radiosurgery-

Masami Takanashi1, YOSHIMARU OZAKI2, KENICHI SATOU2, MITHUTERU OIKAWA2, HIROHIKO NAKAMURA2, SEIJI FUKUOKA3

1Chuouku Sapporo, Japan 2NAKAMURA MEMORIAL HOSPITAL 3FUKUOKA CLINIC

Keywords: dural arteriovenous fistula, gamma knife, arteriovenous fistula, embolization, outcome

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Abstract

     A case of dural arteriovenous fistula(DAVF) around the anterior condylar confluent(ACC) was treated with simultaneous treatment with endovascular techniques and gamma knife radiosurgery in one day and was reported here.
     Our purpose was to report the outcome of a DAVF in this location.
     This was a single patient case report.
     A 61-year-old-man presented with audible pulse-synchronous bruit. Angiogram showed DAVF around the anterior condylar confluent(ACC) with fine vessel shuntings . DAVF was fed by the ascending pharyngeal artery(APA) and posterior meningeal artery. At first, streotactic frame for Gamma knife radiosurgery(GKRS) was set on patient’s head. And then, the patient was treated with trans-arterial coil embolization of APA. And the fine vessel shuntings were treated with GKRS simultaneously in one day.
     Follow-up angiogram performed 1-year-after the treatment showed disappearance of DAVF. And the audible bruit was completely improved.
     This was a retrospective review.
     A case of DAVF around the ACC was successfully treated with this strategy.  
     This simultaneous stage of treatment with endovascular techniques and GKRS seems to be safe and effective for the treatment of DAVF around ACC.


Acknowledgements

Project Roles:

M. Takanashi (), Y. OZAKI (), K. SATOU (), M. OIKAWA (), H. NAKAMURA (), S. FUKUOKA ()