{
  "abstract": "Background Endovascular transvenous embolization of spinal cerebrospinal fluid–venous fistulas (CVFs) has been shown in small studies to be a safe and effective treatment for spontaneous intracranial hypotension (SIH).Objective To validate the safety and effectiveness of this procedure and to describe catheterization techniques available to safely perform these embolization procedures.Results A total of 21 patients with confirmed CVF underwent 23 endovascular embolization procedures; 18 (86%) patients achieved both clinical and radiographic resolution of their SIH. There were no major neurologic complications from any procedure. One patient had postoperative pulmonary embolism and deep vein thrombosis. The most common side effects were prolonged symptoms of rebound intracranial hypertension (29%) and prolonged back pain with radiculopathy (24%). The azygous vein was used for catheterizing the level of interest in 83% of embolization procedures; the lumbar ascending vein was used for catheterization in 17% of the procedures; and direct catheterization of the segmental/foraminal vein at the level of interest was performed in 61% of the procedures. The epidural venous plexus was accessed and traversed to the level of interest in 39% of the procedures.Conclusion Endovascular transvenous embolization of CVF is a safe, well-tolerated, and effective treatment for SIH. Given the variability of the venous anatomy, there are multiple routes of catheterization that can be performed to access the level of interest when performing these procedures.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA"
      ],
      "name": "Craig Schreiber"
    },
    {
      "affiliations": [
        "Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA"
      ],
      "name": "Gary Kocharian"
    },
    {
      "affiliations": [
        "Neurosurgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA"
      ],
      "name": "Andrew Garton"
    },
    {
      "affiliations": [
        "Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA"
      ],
      "name": "Natasha Kharas"
    },
    {
      "affiliations": [
        "Department of Radiology, Weill Cornell Medical College, New York, New York, USA"
      ],
      "name": "Bala McRae-Posani"
    },
    {
      "affiliations": [
        "Department of Radiology, Weill Cornell Medical College, New York, New York, USA"
      ],
      "name": "Gayle Salama"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Weill Cornell Medicine, New York, New York, USA"
      ],
      "name": "Justin T Schwarz"
    },
    {
      "affiliations": [
        "Divison of Interventional Neuroradiology, Department of Neurological Surgery, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, New York, USA"
      ],
      "name": "Srikanth R Boddu"
    },
    {
      "affiliations": [
        "Neurosurgery, Weill Cornell Medical College, New York, New York, USA"
      ],
      "name": "Jared Knopman"
    },
    {
      "affiliations": [
        "Department of Neurological Surgery, New York Presbyterian Hospital/Weill Cornell Medical College, New York, New York, USA"
      ],
      "name": "Y Pierre Gobin"
    }
  ],
  "title": "Catheterization techniques and outcomes of transvenous embolization of cerebrospinal fluid–venous fistulas in the management of spontaneous intracranial hypotension: case series",
  "uid": "306c75c6-3c52-5d18-96fc-c6b1bc99deef"
}