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Case series
DSA-Dynavision in pretreatment planning for coil embolization of indirect carotid–cavernous fistula
  1. Alex Botsford,
  2. Jai Jai Shiva Shankar
  1. Department of Diagnostic Imaging, QE II Health Sciences Centre, Halifax, Nova Scotia, Canada
  1. Correspondence to Dr J J S Shankar, Department of Diagnostic Imaging, QEII Health Sciences Centre, 1796 Summer St, Room 3305A, Halifax, Nova Scotia, Canada B3H 3A7; shivajai1{at}gmail.com

Abstract

Introduction Indirect carotid cavernous fistulas are treated with coil embolization when they present with orbital/visual symptoms or if there is cortical venous reflux. Most of the time, the treatment is done by non-specifically packing the whole cavernous sinus with coils. The purpose of this case series was to examine whether DSA-Dynavision before embolization would improve treatment by shortening the procedure time, requiring fewer coils, or reducing the complication rate.

Materials and method 8 patients with 9 fistula sites were retrospectively identified. DSA-Dynavision and non-DSA-Dynavision patients were compared in a retrospective cohort study.

Results Mean total coil length was significantly shorter for the group who had DSA-Dynavision than for those who had non-DSA-Dynavision (130.5 cm vs 190 cm, p=0.034) and mean procedural time was significantly shorter for the DSA-Dynavision group (171.1 min vs 280.3 min, p=0.025). A transient neurological complication was seen in only one patient.

Conclusions The use of DSA-Dynavision in pre-procedural planning facilitates selective coil embolization of the foot of the vein.

  • Coil
  • Intervention
  • Brain
  • CT Angiography

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