Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
권호 표지
DOI QR코드

DOI QR Code

Surgical considerations and techniques using intraoperative indocyanine green angiography for ethmoidal dural arteriovenous fistula

  • Hyeon Gyu Yang (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Su-Hee Cho (Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) ;
  • Hong Beom Kim (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ku Hyun Yang (Department of Neurological Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine)
  • Received : 2023.04.14
  • Accepted : 2023.07.29
  • Published : 2024.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study aims to investigate the efficacy of microsurgery with intraoperative indocyanine green (ICG) angiography as a treatment approach for ethmoidal dural arteriovenous fistula (DAVF). Methods: Between January 2010 and July 2021, our institution encountered a total of eight cases of ethmoidal DAVF. In each of these cases, microsurgical treatment was undertaken utilizing a bilateral sub-frontal interhemispheric approach, with the aid of intraoperative ICG angiography. Results: ICG angiography identified bilateral venous drainage with single dominance in four cases (50%) of ethmoidal DAVF, a finding that eluded detection during preoperative transfemoral cerebral angiography (TFCA). The application of microsurgical treatment, in conjunction with intraoperative ICG angiography, resulted in consistently positive clinical outcomes for all patients, as evaluated using the Glasgow Outcome Scale (GOS) at the 6-month postoperative follow-up assessment; six patients showed GOS score of 5, while the remaining two patients attained a GOS score of 4. Conclusions: The use of intraoperative ICG angiography enabled accurate identification of both dominant and non-dominant venous drainage patterns, ensuring complete disconnection of the fistula and reducing the risk of recurrence.

Keywords

References

  1. Agid R, Terbrugge K, Rodesch G, Andersson T, Soderman M. Management strategies for anterior cranial fossa (ethmoidal) dural arteriovenous fistulas with an emphasis on endovascular treatment. J Neurosurg 2009 Jan;110(1):79-84.
  2. Cannizzaro D, Peschillo S, Cenzato M, Pero G, Resta MC, Guidetti G, et al. Endovascular and surgical approaches of ethmoidal dural fistulas: A multicenter experience and a literature review. Neurosurg Rev. 2018 Apr;41(2):391-8.
  3. Deshmukh VR, Chang S, Albuquerque FC, McDougall CG, Spetzler RF. Bilateral ethmoidal dural arteriovenous fistulae: A previously unreported entity: Case report. Neurosurgery. 2005 Oct;57(4):e809.
  4. Ghobrial GM, Marchan E, Nair AK, Dumont AS, Tjoumakaris SI, Gonzalez LF, et al. Dural arteriovenous fistulas: A review of the literature and a presentation of a single institution's experience. World Neurosurg. 2013 Jul-Aug;80(1-2):94-102.
  5. Giannopoulos S, Texakalidis P, Mohammad Alkhataybeh RA, Charisis N, Rangel-Castilla L, Jabbour P, et al. Treatment of ethmoidal dural arteriovenous fistulas: A meta-analysis comparing endovascular versus surgical treatment. Would Neurosurgery. 2019 Aug;128:593-9.e1.
  6. Gross BA, Moon K, Kalani MY, Albuquerque FC, McDougall CG, Nakaji P, et al. Clinical and anatomic insights from a series of ethmoidal dural arteriovenous fistulas at barrow neurological institute. World Neurosurg. 2016 Sep;93:94-9.
  7. Halbach VV, Higashida RT, Hieshima GB, Wilson CB, Barnwell SL, Dowd CF. Dural arteriovenous fistulas supplied by ethmoidal arteries. Neurosurgery. 1990 May;26(5):816-23.
  8. Kohama M, Nishimura S, Mino M, Hori E, Yonezawa S, Kaimori M, et al. Anterior cranial fossa dural arteriovenous fistula with bilateral cortical drainers--case report. Neurol Med Chir (Tokyo). 2010;50(3):217-20.
  9. Martin NA, King WA, Wilson CB, Nutik S, Carter LP, Spetzler RF. Management of dural arteriovenous malformations of the anterior cranial fossa. 1990 May;72(5):692-7.
  10. Mayfrank L, Reul J, Huffmann B, Bertalanffy H, Spetzger U, Gilsbach JM. Microsurgical interhemispheric approach to dural arteriovenous fistulas of the floor of the anterior cranial fossa. Minim Invasive Neurosurg. 1996 Sep;39(3):74-7.
  11. Morikawa T, Yasui T, Komiyama M, Iwai Y, Yamanaka K, Nishikawa M, et al. Dural arteriovenous fistulae in the anterior cranial fossa--report of three cases. No Shinkei Geka. 2000 Nov;28(11):1009-14.
  12. Sugiyama T, Nakayama N, Ushikoshi S, Kazumata K, Okamoto M, Ito M, et al. Complication rate, cure rate, and long-term outcomes of microsurgery for intracranial dural arteriovenous fistulae: A multicenter series and systematic review. Neurosurg Rev. 2021 Feb;44(1):435-50.
  13. Xu K, Ji T, Li C, Yu J. Current status of endovascular treatment for dural arteriovenous fistulae in the anterior cranial fossa: A systematic literature review. Int J Med Sci. 2019 Jan;16(2):203-11.