Rawanduzy C, Rennert RC, Grandhi R, Couldwell WT. Far lateral craniotomy for disconnection of vertebral dural arteriovenous fistula: how I do it.
Acta Neurochir (Wien) 2022;
165:989-992. [PMID:
36462066 DOI:
10.1007/s00701-022-05437-x]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND
Craniocervical junction (CCJ) vascular abnormalities can be challenging to treat because of the surrounding density of critical neurovascular anatomy. Although most dural arteriovenous fistulas (dAVFs) are now treated with endovascular surgery, dAVFs near the CCJ are often better suited for microsurgical obliteration with precise vascular control.
METHODS
We describe our microsurgical approach to treating dAVFs at the CCJ. This includes a far-lateral approach with a small incision centered over the transverse process of the atlas and circumferential skeletonization of the vertebral artery in addition to clipping the fistula to limit lesion recurrence.
CONCLUSIONS
Definitive microsurgical treatment of CCJ dAVFs can be accomplished using a minimally invasive approach.
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