[Failure of transverse sinus dural fistula embolization using ethanol injection]

J Neuroradiol. 2008 Oct;35(4):230-5. doi: 10.1016/j.neurad.2008.01.001. Epub 2008 May 16.
[Article in French]

Abstract

This is a case report of successful arterial embolization of a dural fistula using absolute alcohol. In this two-part embolization of a dural fistula of the left sagittal venous sinus, the use of n-BCA (n-butyl-cyanoacrylate) was followed by 1 ml of absolute alcohol four months later. The first procedure, using n-BCA via the external carotid, permitted exclusion of the arterial supply coming from the medial meningeal and occipital arteries. Persistence of the blood supply through the internal carotid prompted us to perform the second procedure, to occlude the tentorium marginalis artery, using 1 ml of 95% ethanol. This was followed by a cranial nerve (III) palsy that was reversible. The three-month follow-up was satisfactory, although arteriography after one year showed revascularization of the fistula, which was successfully treated by Onyx. Routinely used in the treatment of superficial vascular malformations, the use of absolute alcohol intracerebrally appears to be unreliable, with results that were only temporary.

Publication types

  • Case Reports

MeSH terms

  • Cerebral Angiography
  • Cranial Sinuses / diagnostic imaging
  • Dimethyl Sulfoxide / administration & dosage
  • Dura Mater / diagnostic imaging
  • Embolization, Therapeutic / methods*
  • Enbucrilate
  • Ethanol / administration & dosage*
  • Humans
  • Injections
  • Intracranial Arteriovenous Malformations / diagnostic imaging
  • Intracranial Arteriovenous Malformations / therapy*
  • Middle Aged
  • Polyvinyls / administration & dosage
  • Treatment Failure

Substances

  • Onyx copolymer
  • Polyvinyls
  • Ethanol
  • Enbucrilate
  • Dimethyl Sulfoxide