Use of frameless stereotactic computed tomography venography for intraoperative localization of dural arterial venous fistulas

case report

Jonathan D. Carlson, James K. Liu, Aclan Dogan, Eric Sincoff, Gregory Anderson, Johnny B. Delashaw

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The following technical case report illustrates the use of multiple imaging modalities including 3D CTV with frameless stereotactic navigation for intraoperative planning and localization for surgical obliteration of a cranial dAVF with leptomeningeal drainage. Case Description: This 65-year-old man presented with an asymptomatic occipital dAVF with leptomeningeal drainage. In addition to cerebral angiography, a CTV with 3D reconstruction was performed, which provided excellent visualization of the dAVF and clarified its pattern of drainage. The dAVF was supplied by a middle meningeal artery branch that drained into an occipital cortical vein, which then retrograde filled the vein of Labbé. Frameless stereotactic navigation with the imported CTV images was used to plan the craniotomy and to localize the leptomeningeal draining vein and vein of Labbé. The draining vein of the fistula was successfully ligated and divided while preserving flow in the vein of Labbé. Postoperative angiogram demonstrated complete obliteration of the dAVF. Conclusion: Integration of a 3D reconstructed CTV with conventional angiographic information optimized our surgical understanding of the spatial anatomy of this dAVF and its pattern of venous drainage. Applying the CTV with frameless stereotaxy allowed for safe obliteration of the dAVF while preserving the vein of Labbé.

Original languageEnglish (US)
Pages (from-to)521-525
Number of pages5
JournalSurgical Neurology
Volume70
Issue number5
DOIs
StatePublished - Nov 2008

Fingerprint

Phlebography
Fistula
Veins
Tomography
Drainage
Meningeal Arteries
Neuronavigation
Cerebral Angiography
Craniotomy
Anatomy
Angiography

Keywords

  • Computed tomography venogram
  • Dural arteriovenous fistula
  • Frameless stereotactic navigation

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Use of frameless stereotactic computed tomography venography for intraoperative localization of dural arterial venous fistulas : case report. / Carlson, Jonathan D.; Liu, James K.; Dogan, Aclan; Sincoff, Eric; Anderson, Gregory; Delashaw, Johnny B.

In: Surgical Neurology, Vol. 70, No. 5, 11.2008, p. 521-525.

Research output: Contribution to journalArticle

Carlson, Jonathan D. ; Liu, James K. ; Dogan, Aclan ; Sincoff, Eric ; Anderson, Gregory ; Delashaw, Johnny B. / Use of frameless stereotactic computed tomography venography for intraoperative localization of dural arterial venous fistulas : case report. In: Surgical Neurology. 2008 ; Vol. 70, No. 5. pp. 521-525.
@article{4a18b353452f4cc7b38e50b3e86d37ab,
title = "Use of frameless stereotactic computed tomography venography for intraoperative localization of dural arterial venous fistulas: case report",
abstract = "Background: The following technical case report illustrates the use of multiple imaging modalities including 3D CTV with frameless stereotactic navigation for intraoperative planning and localization for surgical obliteration of a cranial dAVF with leptomeningeal drainage. Case Description: This 65-year-old man presented with an asymptomatic occipital dAVF with leptomeningeal drainage. In addition to cerebral angiography, a CTV with 3D reconstruction was performed, which provided excellent visualization of the dAVF and clarified its pattern of drainage. The dAVF was supplied by a middle meningeal artery branch that drained into an occipital cortical vein, which then retrograde filled the vein of Labb{\'e}. Frameless stereotactic navigation with the imported CTV images was used to plan the craniotomy and to localize the leptomeningeal draining vein and vein of Labb{\'e}. The draining vein of the fistula was successfully ligated and divided while preserving flow in the vein of Labb{\'e}. Postoperative angiogram demonstrated complete obliteration of the dAVF. Conclusion: Integration of a 3D reconstructed CTV with conventional angiographic information optimized our surgical understanding of the spatial anatomy of this dAVF and its pattern of venous drainage. Applying the CTV with frameless stereotaxy allowed for safe obliteration of the dAVF while preserving the vein of Labb{\'e}.",
keywords = "Computed tomography venogram, Dural arteriovenous fistula, Frameless stereotactic navigation",
author = "Carlson, {Jonathan D.} and Liu, {James K.} and Aclan Dogan and Eric Sincoff and Gregory Anderson and Delashaw, {Johnny B.}",
year = "2008",
month = "11",
doi = "10.1016/j.surneu.2008.04.025",
language = "English (US)",
volume = "70",
pages = "521--525",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - Use of frameless stereotactic computed tomography venography for intraoperative localization of dural arterial venous fistulas

T2 - case report

AU - Carlson, Jonathan D.

AU - Liu, James K.

AU - Dogan, Aclan

AU - Sincoff, Eric

AU - Anderson, Gregory

AU - Delashaw, Johnny B.

PY - 2008/11

Y1 - 2008/11

N2 - Background: The following technical case report illustrates the use of multiple imaging modalities including 3D CTV with frameless stereotactic navigation for intraoperative planning and localization for surgical obliteration of a cranial dAVF with leptomeningeal drainage. Case Description: This 65-year-old man presented with an asymptomatic occipital dAVF with leptomeningeal drainage. In addition to cerebral angiography, a CTV with 3D reconstruction was performed, which provided excellent visualization of the dAVF and clarified its pattern of drainage. The dAVF was supplied by a middle meningeal artery branch that drained into an occipital cortical vein, which then retrograde filled the vein of Labbé. Frameless stereotactic navigation with the imported CTV images was used to plan the craniotomy and to localize the leptomeningeal draining vein and vein of Labbé. The draining vein of the fistula was successfully ligated and divided while preserving flow in the vein of Labbé. Postoperative angiogram demonstrated complete obliteration of the dAVF. Conclusion: Integration of a 3D reconstructed CTV with conventional angiographic information optimized our surgical understanding of the spatial anatomy of this dAVF and its pattern of venous drainage. Applying the CTV with frameless stereotaxy allowed for safe obliteration of the dAVF while preserving the vein of Labbé.

AB - Background: The following technical case report illustrates the use of multiple imaging modalities including 3D CTV with frameless stereotactic navigation for intraoperative planning and localization for surgical obliteration of a cranial dAVF with leptomeningeal drainage. Case Description: This 65-year-old man presented with an asymptomatic occipital dAVF with leptomeningeal drainage. In addition to cerebral angiography, a CTV with 3D reconstruction was performed, which provided excellent visualization of the dAVF and clarified its pattern of drainage. The dAVF was supplied by a middle meningeal artery branch that drained into an occipital cortical vein, which then retrograde filled the vein of Labbé. Frameless stereotactic navigation with the imported CTV images was used to plan the craniotomy and to localize the leptomeningeal draining vein and vein of Labbé. The draining vein of the fistula was successfully ligated and divided while preserving flow in the vein of Labbé. Postoperative angiogram demonstrated complete obliteration of the dAVF. Conclusion: Integration of a 3D reconstructed CTV with conventional angiographic information optimized our surgical understanding of the spatial anatomy of this dAVF and its pattern of venous drainage. Applying the CTV with frameless stereotaxy allowed for safe obliteration of the dAVF while preserving the vein of Labbé.

KW - Computed tomography venogram

KW - Dural arteriovenous fistula

KW - Frameless stereotactic navigation

UR - http://www.scopus.com/inward/record.url?scp=53949121600&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53949121600&partnerID=8YFLogxK

U2 - 10.1016/j.surneu.2008.04.025

DO - 10.1016/j.surneu.2008.04.025

M3 - Article

VL - 70

SP - 521

EP - 525

JO - World Neurosurgery

JF - World Neurosurgery

SN - 1878-8750

IS - 5

ER -