Gefäßverschließende neuroradiologisch-interventionelle Behandlungsmöglichkeiten an der Schädelbasis

Endovaskuläre Techniken eignen sich zur Behandlung komplexer Pathologien an der Schädelbasis. In diesem Artikel werden aktuelle gefäßverschließende Behandlungsmethoden anhand von Beispielen im Rahmen der interdisziplinären Zusammenarbeit vorgestellt.

Abstract

Neurointerventional endovascular techniques have become essential in the management of complex skull base pathologies. This article outlines current vessel-occluding treatment options, emphasizing individualized strategies tailored to vascular anatomy and lesion characteristics. Through illustrative case examples, the paper discusses indications, procedural approaches, and outcomes for neoplastic and vascular lesions such as paragangliomas, juvenile nasopharyngeal angiofibromas, hemangiopericytomas, meningiomas, carotid-cavernous fistulas, dural arteriovenous fistulas, and chronic subdural hematomas. The role of materials such as coils, polyvinyl alcohol (PVA) particles, and liquid embolic agents (e.g., Onyx, EVOH) is examined in detail. Furthermore, it highlights the importance of imaging, interdisciplinary collaboration, and thorough anatomical understanding to ensure safe and effective interventions. The article concludes that endovascular therapies represent a minimally invasive, increasingly refined modality for treating a wide spectrum of skull base disorders.

Kernaussagen

• Endovaskuläre Techniken eignen sich zur Behandlung komplexer Pathologien an der Schädelbasis.

• Das Behandlungsspektrum umfasst unterschiedliche Formen neoplastischer sowie vaskulärer Pathologien.

• Die digitale Subtraktionsangiografie (DSA) bleibt der diagnostische Goldstandard.

• Eine interdisziplinäre Zusammenarbeit zwischen (Neuro-)Radiologie, Neurochirurgie und weiteren Fachbereichen ist notwendig.

• Materialien wie Coils, Flüssigembolisate und PVA-Partikel werden situationsabhängig verwendet.

• Fundierte Kenntnisse der Anatomie und potenzieller Anastomosen sind entscheidend.

• Eine individuelle Nachsorge mit entsprechenden Maßnahmen minimiert Risiken und sichert den Behandlungserfolg.

Schlüsselwörter

Gefäßverschluss - interventionelle Behandlung - Paragangliom - durale arteriovenöse Fistel - chronisches Subduralhämatom

Keywords

vascular occlusion - interventional treatment - paraganglioma - dural arteriovenous fistula - chronic subdural hematoma

Publication History

Article published online:
04 September 2025

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