Embolization of palpebral and orbito-frontal fistulas: technical and anatomical considerations in treating high-flow superficial skin lesions with liquid embolics

J Neurointerv Surg. 2018 Mar;10(3):240-244. doi: 10.1136/neurintsurg-2017-013239. Epub 2017 Oct 11.

Abstract

The treatment of palpebral and periorbital fistulas may be challenging due to the presence of multiple anastomosis with eloquent ophthalmic and intracranial vascular territories. Moreover, cosmetic and functional characteristics of this area pose unique challenges to open surgical approaches and endovascular therapy. We review the advantages and disadvantages of different liquid embolics in treating palpebral and periorbital fistulas as we describe three successfully treated cases. Moreover, we describe important anatomical landmarks that should be considered at the time of treatment of these lesions.

Keywords: embolic; fistula; liquid embolic material.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Arteriovenous Fistula / diagnostic imaging*
  • Arteriovenous Fistula / therapy*
  • Contrast Media / administration & dosage
  • Drug Combinations
  • Embolization, Therapeutic / methods*
  • Eyelids / diagnostic imaging*
  • Eyelids / drug effects
  • Female
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Ophthalmic Artery / diagnostic imaging
  • Ophthalmic Artery / drug effects
  • Polyvinyls / administration & dosage*
  • Tantalum / administration & dosage*
  • Treatment Outcome

Substances

  • Contrast Media
  • Drug Combinations
  • Onyx 18
  • Polyvinyls
  • Tantalum