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Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula

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Abstract

To determine technical success and acute complication rates after endovascular coil packing of the cavernous sinus. Nineteen patients presented with either direct (13) or dural (6) arteriovenous fistula (AVF) and were treated by means of coil embolization of the cavernous sinus. The aim of treatment was complete obliteration of the fistula. In a retrospective study, the degree of obliteration, regression of symptoms as well as complication rates were evaluated. Initial complete obliteration was achieved in 12 patients, subtotal occlusion of the sinus in 6 and incomplete packing with major residual fistula in 1 of the patients. Retreatment was successfully performed in two patients with early recurrence of AVF. Follow-up showed complete occlusion rates in 16 and subtotal obliteration in 3 patients. Chemosis and exophthalmus regressed rapidly in all affected patients. Persistence of cranial nerve deficits was observed in 11 cases. Postinterventional thrombosis of the ophthalmic vein was the only major acute complication (n = 2). Coil embolization of the cavernous sinus in cases with AVF is a complex procedure that is technically feasible and safe in the majority of cases. Adequate anticoagulation is recommended to avoid thrombembolic complications. Long-term outcome has to be determined by further studies.

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Authors and Affiliations

  1. Department of Neuroradiology, Goethe University, Schleusenweg 2-16, Haus 95, 60528, Frankfurt am Main, Germany

    Andrea Bink, Joachim Berkefeld, Friedhelm Zanella & Richard du Mesnil de Rochemont

  2. Department of Ophthalmology, Goethe University, Frankfurt/Main, Germany

    Marc Lüchtenberg

  3. Department of Neurosurgery, Goethe University, Frankfurt/Main, Germany

    Rüdiger Gerlach

  4. Department of Neurology, Goethe University, Frankfurt/Main, Germany

    Tobias Neumann-Haefelin

Authors
  1. Andrea Bink
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  2. Joachim Berkefeld
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  3. Marc Lüchtenberg
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  4. Rüdiger Gerlach
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  5. Tobias Neumann-Haefelin
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  6. Friedhelm Zanella
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  7. Richard du Mesnil de Rochemont
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Correspondence to Andrea Bink.

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Bink, A., Berkefeld, J., Lüchtenberg, M. et al. Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula. Eur Radiol 19, 1443–1449 (2009). https://doi.org/10.1007/s00330-008-1278-1

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  • DOI: https://doi.org/10.1007/s00330-008-1278-1

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