Related Experiment Video
Updated: Jan 22, 2026

Establishment of a Rat Model of Superior Sagittal-Sinus Occlusion via a Thread-Embolism Method
Published on: July 4, 2021
Transarterial Embolization of Dural Arteriovenous Fistula in Superior Sagittal Sinus Under Bilateral External Carotid
Masashi Kotsugi1, Ichiro Nakagawa1, Yoshiaki Takamura1
1Department of Neurosurgery, Nara Medical University, Nara, Japan.
Background:
Transarterial embolization (TAE) using liquid embolic material is a standard treatment for non-sinus-type dural arteriovenous fistula (DAVF). However, to reach embolic material over a shunt point for complete obliteration of DAVF is often difficult. We present a technical case report of the efficacy of bilateral external carotid artery (ECA) flow control for the TAE of superior sagittal sinus DAVF.
Case Description:
A 64-year-old man presented with dizziness and left hemiparesis. Computed tomography imaging showed right parietal subcortical hemorrhage, and cerebral angiography revealed a DAVF in the superior sagittal sinus fed by bilateral occipital artery, bilateral superficial temporal artery and bilateral middle meningeal artery (MMA), with cortical venous reflux and without connection to the superior sagittal sinus. We therefore planned TAE using glue via MMA under bilateral ECA flow control. A 7-Fr balloon guide catheter was positioned in the bilateral ECA origins, and a microcatheter was introduced distal to the MMA. Heated 20% n-butyl-2-cyanoacrylate was slowly injected via the left MMA under bilateral ECA origin flow control. The n-butyl-2-cyanoacrylate reached the shunt point and obliterated the shunt in a single session. The patient was discharged without neurological symptoms.
Conclusions:
Bilateral ECA flow control using balloon guide catheter is safe and effective for a DAVF in the superior sagittal sinus with multiple and tortuous scalp feeders.
Related Concept Videos
General External Flow Characteristics
Control of Power Flow
Pulmonary Embolism I: Introduction
Work Done on a System by External Force
In the presence of a non-conservative opposing force, like friction, some part of the work done...
ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
External and Internal Respiration

