Article Text

Download PDFPDF
Original research
Surgical access on the superior ophthalmic vein to the cavernous sinus dural fistula for embolization
  1. Chuhan Jiang1,
  2. Xianli Lv1,
  3. Youxiang Li1,
  4. Zhongxue Wu1,
  5. Jitong Shi2
  1. 1Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
  2. 2Beijing Tongren Hospital, Capital Medical University, Beijing, China
  1. Correspondence to Dr J Shi, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China; shijitong888{at}


Background Direct surgical exposure and cannulation (DSEC) of the superior ophthalmic vein (SOV) can be used as an alternative approach for the endovascular treatment of cavernous sinus dural fistulas (CSDF) that fail conventional endovascular access. The aim of this study was to report the techniques, effectiveness and safety of DSEC of the SOV in these cases.

Methods Between June 2007 and June 2011, nine CSDF in nine patients who presented with ocular signs and symptoms were embolized using DSEC of the SOV when the CSDF could not be treated via the transarterial or transfemoral venous route.

Results All nine patients were successfully treated by introduction of Onyx in conjunction with detachable coils through the catheterized SOV to the affected cavernous sinus. No exposure or catheterization of the SOV proved difficult. Symptoms and signs resolved completely in all patients after successful occlusion of the CSDF. There were no intraoperative complications. All patients underwent follow-up cerebral angiography at least 3 months after treatment, and none showed recurrence of the fistula.

Conclusion DSEC of the SOV for embolization of a CSDF is a good alternative treatment when conventional venous routes are inaccessible. Surgical access to the SOV is direct and can be performed safely. The use of Onyx in conjunction with detachable coils is safe and effective for symptomatic CSDF.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors CJ and XL contributed equally to this research.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The study was approved by the institutional review board.

  • Provenance and peer review Not commissioned; externally peer reviewed.