Anatomic Variation of Facial Vein in Carotid-Cavernous Fistula and Trans-Facial Vein Embolization

World Neurosurgery
Chao-Bao LuoTa-Wei Ting

Abstract

Trans-facial vein (FV) embolization via the internal jugular vein is an alternative approach to embolization of carotid cavernous fistulas (CCFs). The purpose of this study is to report the anatomic variation of FVs and our experience of trans-FV embolization of CCFs. Over 6 years, 26 patients (12 men and 14 women; age range 27-72 years old) with CCFs underwent trans-FV embolization because of anterior drainage of fistulas. We retrospectively analyzed angioarchitecture of the CCFs focusing on the anatomic variations of FVs and angiographic and clinical outcomes after embolization. FVs drained to the internal jugular vein in 10 (38%) cases; FVs unexpectedly emptied into the external jugular vein in 16 (62%) cases. All FVs entered into the internal jugular vein at the level of the hyoid bone. In cases with fistulas to the FV and EJV, the termination of FVs was variable including superior (n = 5), inferior (n = 1), or at the level of the hyoid bone (n = 10). Successful microcatheterization via different insertions of FVs to jugular veins was achieved in all cases. One patient had a small residual fistula, and 2 patients had fistula recurrence. Temporary impairment of cranial nerve III or VI occurred in 4 patients. The mean clinica...Continue Reading

References

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Citations

Dec 31, 2019·Journal of Cerebrovascular and Endovascular Neurosurgery·Woong HanJoo Seung Kim
Oct 16, 2021·AJNR. American Journal of Neuroradiology·K D BhatiaV M Pereira

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