Interpositional dural graft technique for the treatment of dural arteriovenous fistulas. 2007

Michael Finn, and Paul Klimo, and William T Couldwell
Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132, USA.

Dural arteriovenous fistulas (dAVFs) are acquired direct arteriovenous shunts that often drain into the dural venous sinus. Treatment options generally involve disrupting the abnormal vascular conduits by using a combination of modalities, including surgical disconnection, radiosurgery, and transarterial and transvenous embolization. Often these modalities provide only partial treatment of fistulous lesions, and thus the fistula recurs and symptoms result. The authors report on a novel surgical technique in which the involved venous sinuses are skeletonized and an interpositional dural substitute is placed between the disconnected sinus and native dura mater and over the pial surface adjacent to the sinus. The technique, which is demonstrated in an illustrative case, is intended to preserve native venous drainage and to prevent recruitment of new vascularization to the venous sinus postoperatively. The authors have not observed reconstitution of fistulas over areas treated with this technique, which offers the advantage of inhibiting vascular ingrowth (refistulization) while maintaining venous sinus patency.

UI MeSH Term Description Entries
D008297 Male Males
D002417 Cattle Domesticated bovine animals of the genus Bos, usually kept on a farm or ranch and used for the production of meat or dairy products or for heavy labor. Beef Cow,Bos grunniens,Bos indicus,Bos indicus Cattle,Bos taurus,Cow,Cow, Domestic,Dairy Cow,Holstein Cow,Indicine Cattle,Taurine Cattle,Taurus Cattle,Yak,Zebu,Beef Cows,Bos indicus Cattles,Cattle, Bos indicus,Cattle, Indicine,Cattle, Taurine,Cattle, Taurus,Cattles, Bos indicus,Cattles, Indicine,Cattles, Taurine,Cattles, Taurus,Cow, Beef,Cow, Dairy,Cow, Holstein,Cows,Dairy Cows,Domestic Cow,Domestic Cows,Indicine Cattles,Taurine Cattles,Taurus Cattles,Yaks,Zebus
D002533 Cerebral Angiography Radiography of the vascular system of the brain after injection of a contrast medium. Angiography, Cerebral,Angiographies, Cerebral,Cerebral Angiographies
D002536 Cerebral Arteries The arterial blood vessels supplying the CEREBRUM. Arteries, Cerebral,Artery, Cerebral,Cerebral Artery
D002560 Cerebrovascular Circulation The circulation of blood through the BLOOD VESSELS of the BRAIN. Brain Blood Flow,Regional Cerebral Blood Flow,Cerebral Blood Flow,Cerebral Circulation,Cerebral Perfusion Pressure,Circulation, Cerebrovascular,Blood Flow, Brain,Blood Flow, Cerebral,Brain Blood Flows,Cerebral Blood Flows,Cerebral Circulations,Cerebral Perfusion Pressures,Circulation, Cerebral,Flow, Brain Blood,Flow, Cerebral Blood,Perfusion Pressure, Cerebral,Pressure, Cerebral Perfusion
D003392 Cranial Sinuses Large endothelium-lined venous channels situated between the two layers of DURA MATER, the endosteal and the meningeal layers. They are devoid of valves and are parts of the venous system of dura mater. Major cranial sinuses include a postero-superior group (such as superior sagittal, inferior sagittal, straight, transverse, and occipital) and an antero-inferior group (such as cavernous, petrosal, and basilar plexus). Cranial Venous Sinuses,Intracranial Sinuses,Sinuses, Cranial,Sinuses, Cranial Venous,Sinuses, Intracranial,Venous Sinuses, Cranial
D004388 Dura Mater The outermost of the three MENINGES, a fibrous membrane of connective tissue that covers the brain and the spinal cord. Falx Cerebelli,Falx Cerebri,Pachymeninx,Tentorium Cerebelli
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia

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