RESUMEN
BACKGROUND: The sphenoid wing dural arteriovenous fistula (AVF) is rare, and can manifest with severe symptoms, particularly in cases classified as greater sphenoid wing type. Endovascular therapy is generally employed, however, open surgical intervention could be warranted in cases with complex fistula. METHOD: We present a case with ruptured greater sphenoid wing dural AVF (Cognard type IV), in which endovascular embolization using liquid material was performed, followed by open surgery to concurrently disconnect the fistula and evacuate the hematoma. CONCLUSION: The sphenoid wing dural AVFs may be effectively cured by open surgery for fistula disconnection in conjunction with endovascular embolization.
Asunto(s)
Malformaciones Vasculares del Sistema Nervioso Central , Embolización Terapéutica , Humanos , Malformaciones Vasculares del Sistema Nervioso Central/cirugía , Malformaciones Vasculares del Sistema Nervioso Central/diagnóstico por imagen , Malformaciones Vasculares del Sistema Nervioso Central/terapia , Embolización Terapéutica/métodos , Masculino , Procedimientos Endovasculares/métodos , Hueso Esfenoides/cirugía , Hueso Esfenoides/diagnóstico por imagen , Resultado del Tratamiento , Persona de Mediana Edad , Femenino , Angiografía CerebralRESUMEN
BACKGROUND: Common carotid artery occlusion (CCAO) is rare, where a revascularization procedure might be needed in symptomatic or recurrent ischemic events. In this study, we describe the carotid-carotid artery crossover bypass technique for Riles type 1 A CCAO. METHODS: The procedure was conducted via bilateral neck incisions utilizing the saphenous vein graft. The graft was patent after surgery, along with substantial improvement in cerebral perfusion, resulting in a stroke-free postoperative period. CONCLUSION: The carotid-carotid crossover bypass is effective for CCAO patients requiring revascularization. However, individual bypass options and vascular grafts should be carefully considered.
