RT Journal Article
SR Electronic
T1 Surgical access on the superior ophthalmic vein to the cavernous sinus dural fistula for embolization
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP e13
OP e13
DO 10.1136/neurintsurg-2011-010227
VO 5
IS 3
A1 Chuhan Jiang
A1 Xianli Lv
A1 Youxiang Li
A1 Zhongxue Wu
A1 Jitong Shi
YR 2013
UL http://jnis.bmj.com/content/5/3/e13.abstract
AB 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.