RT Journal Article
SR Electronic
T1 Stereotactic-guided direct orbital puncture for treatment of orbital arteriovenous fistula
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 429
OP 429
DO 10.1136/jnis-2023-020145
VO 16
IS 4
A1 Robledo, Ariadna
A1 Frank, Thomas S
A1 Karas, Patrick J
A1 Shaltoni, Hashem
A1 O'Leary, Sean
A1 Darling, Robert
A1 Kan, Peter
YR 2024
UL http://jnis.bmj.com/content/16/4/429.abstract
AB The patient presented with left-sided chemosis, exophthalmos, and progressive visual loss. Cerebral angiography ed a left orbital arteriovenous malformation and an associated hematoma, with the point of fistulation between the left ophthalmic artery and the anterior section of the inferior ophthalmic vein, with retrograde flow through the superior ophthalmic vein. Transvenous embolization through the anterior facial and angular veins was unsuccessful, with residual shunting. Stereotactic-guided direct venous puncture and Onyx embolization was subsequently performed in the hybrid operating room (OR) to cure the fistula. A subciliary incision allowed for retraction of the orbital contents, creating an optimal trajectory. An endonasal endoscopic approach was performed after the embolization to decompress the orbit. This procedure is shown in video 1.1–11 Video 1