Embolisation of indirect carotid-cavernous sinus dural arterio-venous fistulae using the direct superior ophthalmic vein approach

被引:23
作者
Lee, J. -W. [1 ]
Kim, D. -J. [2 ]
Jung, J. -Y. [1 ]
Kim, S. -H. [1 ]
Huh, S. -K. [1 ]
Suh, S. -H. [2 ]
Kim, D. -I. [2 ]
机构
[1] Yonsei Univ, Coll Med, Brain Res Inst, Dept Neurosurg, Seoul 120752, South Korea
[2] Yonsei Univ, Coll Med, Brain Res Inst, Dept Radiol, Seoul 120752, South Korea
关键词
indirect; carotid-cavernous sinus; dural arteriovenous fistula; embolisation; direct superior ophthalmic vein approach;
D O I
10.1007/s00701-008-1573-2
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Indirect carotid-cavernous sinus dural arterio-venous fistulae (cDAVF) can be treated by transarterial and/or transvenous embolisation. This study evaluated patients with cDAVF who underwent transvenous embolisation using the direct superior ophthalmic vein (SOV) approach. Between January 2004 and October 2006, eight cDAVF in seven patients were embolised using direct surgical exposure of the SOV when access to the cDAVF via transarterial or transfemoral venous routes was not feasible. Medical records and imaging studies were retrospectively reviewed. The seven patients consisted of four females and three males from 43 to 65-year-old (mean age, 54.4 years). Six cDAVF lesions were located on the left side and two on the right. All fistulae were successfully embolised and showed clinical improvement. One patient presented after treatment with transient venous congestion on the brain stem, which was relieved by osmotic diuretics and steroids. Direct surgical exposure of the SOV for transvenous embolisation of cDAVF can be effective if the facial vein, inferior petrosal sinus, and internal jugular vein are thrombosed. This approach is easy, safe, and effective when performed by a multidisciplinary team.
引用
收藏
页码:557 / 561
页数:5
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