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07-12-2022 | Arteriovenous Fistula | Original Article

Ventral Clival Branch of the Ascending Pharyngeal Artery as a Transosseous Feeder of an Arteriovenous Fistula Surrounding the Clival Lesions

Authors: Wataro Tsuruta, Tomokazu Sekine, Daiichiro Ishigami, Shigeta Fujitani, Arisa Tomioka, Yuki Kamiya, Hisayuki Hosoo, Yoshiro Ito, Aiki Marushima, Mikito Hayakawa, Yuji Matsumaru

Published in: Clinical Neuroradiology | Issue 2/2023

Abstract

Purpose

Arteriovenous fistulas (AVFs) adjacent to the clivus, such as cavernous sinus dural AVFs (CSDAVFs) and condylar AVFs, sometimes have an intraosseous shunted pouch and recruit blood supply from transosseous feeders. Precise analysis of transosseous feeders regarding the clival lesion has not yet been performed. Therefore, this study aimed to clarify the characteristics and identity of transosseous feeders in clival lesions.

Methods

Patients with CSDAVFs and condylar AVFs, who underwent high-resolution cone-beam computed tomography or three-dimensional rotational angiography in our institute, were included. The frequency, type of branch, penetrating point, and termination of intraosseous feeders were retrospectively evaluated.

Results

A total of 31 patients with 36 lesions in CSDAVFs and 8 patients with 8 lesions in condylar AVFs underwent angiography. For CSDAVFs, 38 transosseous feeders were detected in 23 out of 31 patients, including 22 in the pharyngeal branch of the ascending pharyngeal artery (APhA), 6 in the hypoglossal branch of the APhA, 6 in the accessory meningeal artery, 3 in the meningohypophyseal trunk (MHT), and 1 in the anterior branch of the middle meningeal artery. For condylar AVFs, 24 transosseous feeders were detected in all 8 patients, including 11 in the pharyngeal branches of the APhA, 7 in the hypoglossal branch of the APhA, 6 in the segmental artery from the vertebral artery, and 2 in the MHT.

Conclusion

Transosseous feeders of AVFs around the clivus, which are frequently seen in AVFs of this area, mainly arise from ventral clival branches and from pharyngeal branches of the APhA.

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Title: Ventral Clival Branch of the Ascending Pharyngeal Artery as a Transosseous Feeder of an Arteriovenous Fistula Surrounding the Clival Lesions
Authors: Wataro Tsuruta
Tomokazu Sekine
Daiichiro Ishigami
Shigeta Fujitani
Arisa Tomioka
Yuki Kamiya
Hisayuki Hosoo
Yoshiro Ito
Aiki Marushima
Mikito Hayakawa
Yuji Matsumaru
Publication date: 07-12-2022
Publisher: Springer Berlin Heidelberg
Keywords: Arteriovenous Fistula
Arteriovenous Fistula
Published in: Clinical Neuroradiology / Issue 2/2023
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI: https://doi.org/10.1007/s00062-022-01232-4

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Ventral Clival Branch of the Ascending Pharyngeal Artery as a Transosseous Feeder of an Arteriovenous Fistula Surrounding the Clival Lesions

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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