Case of Dr. Eytan Raz
Yes, yes, sure — there are many examples of this being done via the occluded inferior petrosal sinus (one example here). Still, to our knowledge, access via occluded superior petrosal sinus — this looks like the first time? Anyone know any different? If yes give pictures…
That’s the way it was, before sinus got occluded by high-flow venopathy (the mechanism by which arterialized veins / sinuses close)
Treatment — transvenous access — Arrow 8F 80 cm, Sofia 6, Headway Duo, Aristotle 14 standard
Venous phase vert injection to best show the patent Sigmoid side of the SPS
A bit more manipulation, and duo is on the arterial side in the posterior clival arcade of the MHT. The fistula pouch is circled in white.
To be sure, coiling off major venous connections to the pouch. Probably unnecessary, but don’t want to be painted into corner and leave the sylvian connection open
More superselective embolization cases here