AJDRAJNR - American Journal of Neuroradiology

This Article
Right arrow Abstract Freely available
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Weill, A.
Right arrow Articles by Raymond, J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Weill, A.
Right arrow Articles by Raymond, J.

Use of the Trispan Device to Assist Coil Embolization of High-Flow Arteriovenous Fistulas

Alain Weilla, Daniel Roya, Stavros A. Georganosa, François Guilberta and Jean Raymonda

a From the Centre Hospitalier Universite de Montreal, Pavillon Notre-Dame, Radiology Department, Interventional Neuroradiology Unit



View larger version (69K):

[in a new window]
  		FIG 1. Case 1.

A, Vertebral angiogram in the oblique view shows a mural-type vein of Galen malformation. The microcatheter used for coil deployment (arrowhead) was introduced through a posterior choroidal artery. The Trispan device (arrow) is deployed at the outlet of the venous pouch by retrograde venous approach. Two coils from the previous transarterial embolization procedure are depicted.

B, Angiogram obtained during embolization shows several coils detached in the venous pouch under the protection afforded by the Trispan device.

C, Final angiogram (same projection as in A) shows nearly complete obliteration of the malformation. Note a minimal residual opacification of the straight sinus (arrow).



View larger version (111K):

[in a new window]
  		FIG 2. Case 2.

A and B, Lateral right common carotid angiograms. Early phase image (A) shows the right transverse dural fistula. Parenchymal phase image (B) shows reflux in the straight, superior sagittal, and left transverse sinuses from the right transverse dural fistula. The right vein of Labbé (arrowheads in B) is opacified in a retrograde fashion.

C, Lateral venous phase angiogram obtained with a right internal carotid injection shows cerebral venous congestion. Despite retrograde flow in the right vein of Labbé (see image in B), antegrade flow (arrowheads) persists.

D, Schematic drawing of the cerebral venous drainage (left anterior oblique view) in patient 2 during embolization. The Trispan device is deployed to prevent loops of coils from being positioned in front of the right vein of Labbé.

E and F, Lateral angiograms obtained with a right common carotid injection 3 months after endovascular treatment. Arterial phase image (E) depicts cure of the right transverse dural fistula. Venous phase image (F) shows improvement in cerebral venous drainage and antegrade flow in the right vein of Labbé (arrowheads).





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X