Transvenous embolization of cerebrospinal fluid-venous fistulas: A comprehensive technical video guide

Abstract

Cerebrospinal fluid (CSF)-venous fistulas necessitate a comprehensive understanding of spinal venous anatomy for successful embolization.¹ This video details the essential technical and anatomical nuances of CSF-venous fistula embolization at various spinal levels, including the cervical, thoracic, and lumbar spine. Precise microcatheter navigation, guided by a detailed understanding of spinal venous anatomy, is crucial for reaching the fistula site and successful treatment. Embolization typically focuses on the foraminal vein, paraspinal vein, and lateral epidural plexus, aiming to create a comprehensive liquid embolic plug.² As experience with this procedure grows, continued refinement of techniques and exploration of optimal access routes will further enhance success rates.

Keywords

CSF-venous fistula CSF leak foraminal vein embolization venous anatomy

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References

Borg

Cutsforth-Gregory

Oushy

, et al. Anatomy of spinal venous drainage for the neurointerventionalist: from puncture site to intervertebral foramen. AJNR Am J Neuroradiol 2022; 43: 517–525.

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, et al. Transvenous embolization of a cerebrospinal fluid–venous fistula for the treatment of spontaneous intracranial hypotension. J Neurointerv Surg 2022; 14: 948–948.

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