Onyx embolization of cavernous sinus dural arteriovenous fistulas via direct transorbital puncture under the guidance of three-dimensional reconstructed skull image (reports of six cases)

被引:14
作者
Liu, Aihua [1 ]
Liu, Jie [1 ]
Qian, Zenghui [1 ]
Peng, Tangming [1 ]
Li, Youxiang [1 ]
Yang, Jun [1 ]
Wu, Zhongxue [1 ]
Jiang, Chuhan [1 ]
机构
[1] Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Dept Intervent Neuroradiol, Beijing 100050, Peoples R China
基金
中国国家自然科学基金;
关键词
Arteriovenous fistula; Embolization; Puncture; Superior orbital fissure;
D O I
10.1007/s00701-014-2037-5
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Because of complex angioarchitecture, the transarterial or venous pathway is not feasible for some cavernous sinus dural arteriovenous fistulas (CS DAVFs). We present six cases in which onyx embolization of a CS DAVFs was made possible through direct transorbital puncture. In the present study, all patients were penetrated through one third of the medial-lateral of the inferior orbital rim under the guidance of fluoroscopy superimposed on the three-dimensional reconstructed skull image to complete embolization (onyx with or without coils). The records of patient demographics, clinical manifestation, fistula features, procedures, clinical outcome and angiographic outcome were reviewed and analyzed. In our series of six patients, the immediate angiographic result showed complete occlusion in all patients. The six patients experienced retrobulbarhematoma and eye swelling right after embolization, while the swelling significantly subsided after 3-5 days of conservative treatment. During the postoperative angiography and clinical follow-up (4-10 months), one of the patients had decreased visual acuity; the other five patients did not have neurological dysfunction. Onyx embolization via direct transorbital puncture provides a method to be considered to treat CS DAVFs when the conventional transvenous approaches are inaccessible.
引用
收藏
页码:897 / 900
页数:4
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