Technical Tips for CT-Guided Fibrin Glue Patching of CSF-Venous Fistulas

Fibrin glue patching can be an effective treatment for CSF-venous fistulas, along with transvenous embolization and surgical ligation.^1,2 The technique differs from routine epidural patching, which is typically targeted in the dorsal or ventral epidural spaces. Instead, fibrin glue patching for CSF-venous fistulas is specifically targeted to the venous drainage pattern.³ There are 3 main locations to target: 1) the cyst-vein junction, 2) paravertebral "wall," and 3) direct cyst puncture, and the goal is to sever the connection between the cyst and vein. In this video, technical tips for successful patching will be illustrated for these target locations.