{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:09:10Z","timestamp":1780052950407,"version":"3.54.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"19","license":[{"start":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T00:00:00Z","timestamp":1730678400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,11,4]]},"abstract":"\n BACKGROUND<\/jats:title>\n Selective shunt occlusion (SSO) for intracranial dural arteriovenous fistulas (DAVFs) is a safe and effective method that directly intercepts the shunted pouch from the affected sinus with minimal materials. However, it can be challenging to obliterate the shunted pouch if the microcatheter is not supported adequately.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 68-year-old woman presented with tinnitus and was diagnosed with multiple shunted DAVFs in the right transverse-sigmoid sinus (TSS) and the superior sagittal sinus (SSS). Although the entire sinus packing of the right TSS was performed, a follow-up angiography 7 months later revealed significant cerebral venous reflux due to occlusion of the left TSS and an increasing residual shunt flow in the venous pouch at the confluence of the SSS. A guiding catheter was introduced into the isolated sinus transvenously. Then, a steerable intermediate catheter (SIC) was manually steered into a hairpin shape and hooked on near the pouch prior to navigating a microcatheter into the fistula point. Finally, the fistula pouch was completely obliterated using only two coils under the adequate support of the turned-back intermediate catheter.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The turn-back supporting technique using an SIC was useful in achieving SSO for DAVFs, providing both adequate support and guidance for the coaxial microcatheter.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24467<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24467","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T01:45:35Z","timestamp":1730684735000},"source":"Crossref","is-referenced-by-count":1,"title":["Utility of the turn-back supporting technique using a steerable intermediate catheter: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Takeshi","family":"Hara","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daizo","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Kuwabara","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobutaka","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"J Neurosurg Sci","first-page":"437","article-title":"Natural history of brain arteriovenous malformations: systematic review","volume":"62","author":"Goldberg","year":"2018","unstructured":"Goldberg JRaabe ABervini D. Natural history of brain arteriovenous malformations: systematic review. J Neurosurg Sci. 2018;62(4):437-443."},{"issue":"6","key":"bib2","series-title":"Neurosurgery","first-page":"1119","article-title":"Treatment for intracranial dural arteriovenous malformations: a meta-analysis from the English language literature","volume":"40","author":"Lucas","year":"1997","unstructured":"Lucas CPZabramski JMSpetzler RFJacobowitz R. Treatment for intracranial dural arteriovenous malformations: a meta-analysis from the English language literature. Neurosurgery. 1997;40(6):1119-1130."},{"issue":"suppl","key":"bib3","series-title":"Neurosurgery","first-page":"S42","article-title":"Endovascular treatment of Intracrainal dural arteriovenous fistulas","volume":"74","author":"Vanlandingham","year":"2014","unstructured":"Vanlandingham MFox BHoit DElijovich LArthur AS. Endovascular treatment of Intracrainal dural arteriovenous fistulas. Neurosurgery. 2014;74(suppl 1):S42-S49."},{"key":"bib4","series-title":"World Neurosurg","first-page":"609","article-title":"Predictive factors for response of intracranial dural arteriovenous fistulas to transarterial Onyx embolization: angiographic subgroup analysis of treatment outcomes","volume":"88","author":"Kim","year":"2016","unstructured":"Kim BJeon PKim K, et al. Predictive factors for response of intracranial dural arteriovenous fistulas to transarterial Onyx embolization: angiographic subgroup analysis of treatment outcomes. World Neurosurg. 2016;88:609-618."},{"issue":"6","key":"bib5","series-title":"Interv Neuroradiol","first-page":"711","article-title":"Transarterial venous sinus occlusion of dural arteriovenous fistulas using ONYX","volume":"22","author":"Torok","year":"2016","unstructured":"Torok CMNogueira RGYoo AJ, et al. Transarterial venous sinus occlusion of dural arteriovenous fistulas using ONYX. Interv Neuroradiol. 2016;22(6):711-716."},{"issue":"6","key":"bib6","series-title":"Radiographics","first-page":"1637","article-title":"Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization","volume":"24","author":"Kiyosue","year":"2004","unstructured":"Kiyosue HHori YOkahara M, et al. Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization. Radiographics. 2004;24(6):1637-1653."},{"issue":"1","key":"bib7","series-title":"Neurosurgery","first-page":"ons100","article-title":"Superselective shunt occlusion for the treatment of cavernous sinus dural arteriovenous fistulae","volume":"73","author":"Satow","year":"2013","unstructured":"Satow TMurao KMatsushige TFukuda KMiyamoto SIihara K. Superselective shunt occlusion for the treatment of cavernous sinus dural arteriovenous fistulae. Neurosurgery. 2013;73(1suppl Operative):ons100-105."},{"issue":"1","key":"bib8","series-title":"J Geriatr Cardiol","first-page":"54","article-title":"Steerable microcatheters for complex percutaneous coronary interventions in octogenarians: from Venture to Swift Ninja","volume":"16","author":"Kassimis","year":"2019","unstructured":"Kassimis GKontogiannis NRaina T. Steerable microcatheters for complex percutaneous coronary interventions in octogenarians: from Venture to Swift Ninja. J Geriatr Cardiol. 2019;16(1):54-59."},{"issue":"4","key":"bib9","series-title":"IEEE Trans Bio Med Eng","first-page":"679","article-title":"Steerable catheters in cardiology: classifying steerability and assessing future challenges","volume":"63","author":"Ali","year":"2016","unstructured":"Ali APlettenburg DHBreedveld P. Steerable catheters in cardiology: classifying steerability and assessing future challenges. IEEE Trans Bio Med Eng. 2016;63(4):679-693."},{"issue":"2","key":"bib10","series-title":"J Neurointerv Surg","first-page":"172","article-title":"New concept in neurovascular navigation: technical description and preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model","volume":"15","author":"Berenstein","year":"2023","unstructured":"Berenstein ACabiri OBroussalis EHufnagl CKiller-Oberpfalzer M. New concept in neurovascular navigation: technical description and preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model. 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Stroke Vasc Neurol. 2020;5(1):50-58."},{"issue":"4","key":"bib1","series-title":"J Neurosurg Sci","first-page":"437","article-title":"Natural history of brain arteriovenous malformations: systematic review","volume":"62","author":"Goldberg","year":"2018","unstructured":"Goldberg JRaabe ABervini D. Natural history of brain arteriovenous malformations: systematic review. J Neurosurg Sci. 2018;62(4):437-443."},{"issue":"6","key":"bib2","series-title":"Neurosurgery","first-page":"1119","article-title":"Treatment for intracranial dural arteriovenous malformations: a meta-analysis from the English language literature","volume":"40","author":"Lucas","year":"1997","unstructured":"Lucas CPZabramski JMSpetzler RFJacobowitz R. Treatment for intracranial dural arteriovenous malformations: a meta-analysis from the English language literature. Neurosurgery. 1997;40(6):1119-1130."},{"issue":"suppl","key":"bib3","series-title":"Neurosurgery","first-page":"S42","article-title":"Endovascular treatment of Intracrainal dural arteriovenous fistulas","volume":"74","author":"Vanlandingham","year":"2014","unstructured":"Vanlandingham MFox BHoit DElijovich LArthur AS. Endovascular treatment of Intracrainal dural arteriovenous fistulas. Neurosurgery. 2014;74(suppl 1):S42-S49."},{"key":"bib4","series-title":"World Neurosurg","first-page":"609","article-title":"Predictive factors for response of intracranial dural arteriovenous fistulas to transarterial Onyx embolization: angiographic subgroup analysis of treatment outcomes","volume":"88","author":"Kim","year":"2016","unstructured":"Kim BJeon PKim K, et al. Predictive factors for response of intracranial dural arteriovenous fistulas to transarterial Onyx embolization: angiographic subgroup analysis of treatment outcomes. World Neurosurg. 2016;88:609-618."},{"issue":"6","key":"bib5","series-title":"Interv Neuroradiol","first-page":"711","article-title":"Transarterial venous sinus occlusion of dural arteriovenous fistulas using ONYX","volume":"22","author":"Torok","year":"2016","unstructured":"Torok CMNogueira RGYoo AJ, et al. Transarterial venous sinus occlusion of dural arteriovenous fistulas using ONYX. Interv Neuroradiol. 2016;22(6):711-716."},{"issue":"6","key":"bib6","series-title":"Radiographics","first-page":"1637","article-title":"Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization","volume":"24","author":"Kiyosue","year":"2004","unstructured":"Kiyosue HHori YOkahara M, et al. Treatment of intracranial dural arteriovenous fistulas: current strategies based on location and hemodynamics, and alternative techniques of transcatheter embolization. Radiographics. 2004;24(6):1637-1653."},{"issue":"1","key":"bib7","series-title":"Neurosurgery","first-page":"ons100","article-title":"Superselective shunt occlusion for the treatment of cavernous sinus dural arteriovenous fistulae","volume":"73","author":"Satow","year":"2013","unstructured":"Satow TMurao KMatsushige TFukuda KMiyamoto SIihara K. Superselective shunt occlusion for the treatment of cavernous sinus dural arteriovenous fistulae. Neurosurgery. 2013;73(1suppl Operative):ons100-105."},{"issue":"1","key":"bib8","series-title":"J Geriatr Cardiol","first-page":"54","article-title":"Steerable microcatheters for complex percutaneous coronary interventions in octogenarians: from Venture to Swift Ninja","volume":"16","author":"Kassimis","year":"2019","unstructured":"Kassimis GKontogiannis NRaina T. Steerable microcatheters for complex percutaneous coronary interventions in octogenarians: from Venture to Swift Ninja. J Geriatr Cardiol. 2019;16(1):54-59."},{"issue":"4","key":"bib9","series-title":"IEEE Trans Bio Med Eng","first-page":"679","article-title":"Steerable catheters in cardiology: classifying steerability and assessing future challenges","volume":"63","author":"Ali","year":"2016","unstructured":"Ali APlettenburg DHBreedveld P. Steerable catheters in cardiology: classifying steerability and assessing future challenges. IEEE Trans Bio Med Eng. 2016;63(4):679-693."},{"issue":"2","key":"bib10","series-title":"J Neurointerv Surg","first-page":"172","article-title":"New concept in neurovascular navigation: technical description and preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model","volume":"15","author":"Berenstein","year":"2023","unstructured":"Berenstein ACabiri OBroussalis EHufnagl CKiller-Oberpfalzer M. New concept in neurovascular navigation: technical description and preclinical experience with the Bendit 17 and Bendit 21 microcatheters in a rabbit aneurysm model. J Neurointerv Surg. 2023;15(2):172-175."},{"issue":"9","key":"bib11","series-title":"Cureus","first-page":"e3337","article-title":"Welcome to the new era: a completely wireless interventional procedure","volume":"10","author":"Martin","year":"2018","unstructured":"Martin JTHulsberg PCSoule EShabandi MMatteo J. Welcome to the new era: a completely wireless interventional procedure. Cureus. 2018;10(9):e3337."},{"issue":"8","key":"bib12","series-title":"J Neurointerv Surg","first-page":"771","article-title":"Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment","volume":"15","author":"Killer-Oberpfalzer","year":"2023","unstructured":"Killer-Oberpfalzer MChapot ROrion DBarr JDCabiri OBerenstein A. Clinical experience with the Bendit steerable microcatheter: a new paradigm for endovascular treatment. J Neurointerv Surg. 2023;15(8):771-775."},{"key":"bib13","series-title":"Interv Neuroradiol","article-title":"Initial clinical experience with the Bendit steerable articulating tip microcatheter for intracranial access and","author":"Qiao","year":"2023","unstructured":"Qiao YZhang YJTsappidi SMehta TIHui FK. Initial clinical experience with the Bendit steerable articulating tip microcatheter for intracranial access and intervention. Interv Neuroradiol. Published online August 7, 2023. doi: 10.1177\/15910199231193931."},{"issue":"8","key":"bib14","series-title":"J Neuroendovasc Ther","first-page":"153","article-title":"Utility of a steerable microcatheter for the selective transvenous embolization of dural arteriovenous fistulas","volume":"17","author":"Tokuyama","year":"2023","unstructured":"Tokuyama KKiyosue HHori YOkahara MNagatomi HAsayama Y. Utility of a steerable microcatheter for the selective transvenous embolization of dural arteriovenous fistulas. J Neuroendovasc Ther. 2023;17(8):153-158."},{"issue":"6","key":"bib15","series-title":"AJNR Am J Neuroradiol","first-page":"E88","article-title":"Turn-back embolization technique for effective transvenous embolization of dural arteriovenous fistulas","volume":"33","author":"Tanoue","year":"2012","unstructured":"Tanoue SKiyosue HHori YAbe TMori H. Turn-back embolization technique for effective transvenous embolization of dural arteriovenous fistulas. AJNR Am J Neuroradiol. 2012;33(6):E88-E91."},{"issue":"6","key":"bib16","series-title":"Diagn Interv Imaging","first-page":"681","article-title":"Ethylene vinyl alcohol copolymer (Onyx) embolization of cranial dural arteriovenous fistula via the ascending pharyngeal artery","volume":"97","author":"Sadeh-Gonik","year":"2016","unstructured":"Sadeh-Gonik UGory BRiva R, et al. Ethylene vinyl alcohol copolymer (Onyx) embolization of cranial dural arteriovenous fistula via the ascending pharyngeal artery. Diagn Interv Imaging. 2016;97(6):681-685."},{"issue":"6","key":"bib17","series-title":"Neurosurgery","first-page":"854","article-title":"Transarterial Onyx embolization of intracranial dural fistulas: a prospective cohort, systematic review, and meta-analysis","volume":"82","author":"Sadeh-Gonike","year":"2018","unstructured":"Sadeh-Gonike UMagand NArmoiry X, et al. Transarterial Onyx embolization of intracranial dural fistulas: a prospective cohort, systematic review, and meta-analysis. Neurosurgery. 2018;82(6):854-863."},{"issue":"4","key":"bib18","series-title":"J Neurosurg","first-page":"1123","article-title":"Long-term angiographic results of endovascularly \u201ccured\u201d intracranial dural arteriovenous fistulas","volume":"124","author":"Ambekar","year":"2016","unstructured":"Ambekar SGaynor BGPeterson ECElhammady MS. Long-term angiographic results of endovascularly \u201ccured\u201d intracranial dural arteriovenous fistulas. J Neurosurg. 2016;124(4):1123-1127."},{"issue":"7","key":"bib19","series-title":"Stroke","first-page":"2017","article-title":"Intracranial dural arteriovenous fistulae: clinical presentation and management strategies","volume":"46","author":"Miller","year":"2015","unstructured":"Miller TRGandhi D. Intracranial dural arteriovenous fistulae: clinical presentation and management strategies. Stroke. 2015;46(7):2017-2025."},{"issue":"5","key":"bib20","series-title":"Neuroradiology","first-page":"439","article-title":"Severe pulmonary oedema following therapeutic embolization with Onyx for cerebral arteriovenous malformation","volume":"50","author":"Murugesan","year":"2008","unstructured":"Murugesan CSaravanan SRajkumar JPrasad JBanakal SMuralidhar K. Severe pulmonary oedema following therapeutic embolization with Onyx for cerebral arteriovenous malformation. Neuroradiology. 2008;50(5):439-442."},{"issue":"4","key":"bib21","series-title":"AJNR Am J Neuroradiol","first-page":"510","article-title":"Endovascular management of intracranial dural AVFs: transvenous approach","volume":"43","author":"Bhatia","year":"2022","unstructured":"Bhatia KDLee HKortman H, et al. Endovascular management of intracranial dural AVFs: transvenous approach. AJNR Am J Neuroradiol. 2022;43(4):510-516."},{"issue":"1","key":"bib22","series-title":"Stroke Vasc Neurol","first-page":"50","article-title":"Update in the management of cranial dural arteriovenous fistula","volume":"5","author":"Baharvahdat","year":"2020","unstructured":"Baharvahdat HOoi YCKim WJMowla ACoon ALColby GP. Update in the management of cranial dural arteriovenous fistula. 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