Onyx embolization of a carotid cavernous fistula via direct transorbital puncture

Journal of Neurosurgery
Mohamed Samy ElhammadyMohammad Ali Aziz-Sultan

Abstract

The treatment of indirect carotid cavernous fistulas (CCFs) is challenging and primarily accomplished by endovascular means utilizing a variety of embolic agents. Transvenous access to the cavernous sinus is the preferred method of embolizaiton of indirect CCFs as they are frequently associated with numerous small-caliber meningeal branches. Although the inferior petrosal sinus is the simplest, shortest, and most commonly used venous route to the cavernous sinus, the superior ophthalmic vein, superior petrosal sinus, basilar plexus, and pterygoid plexus present other endovenous options. Occasionally, however, use of these venous routes may not be possible due to vessel tortuosity or sinus thrombosis and occlusion. The authors report a case of an indirect CCF that could not be treated endovascularly due to inability to access the cavernous sinus via a transfemoral transvenous approach. Angiography revealed a small, deeply located superior ophthalmic vein that was thought to be suboptimal for a direct cutdown. The cavernous sinus was cannulated directly via a transorbital approach using fluoroscopic guidance with a 3D skull reconstruction overlay. The fistula was subsequently obliterated using ethylene vinyl alcohol copolymer (On...Continue Reading

Citations

Aug 24, 2013·Journal of Neuro-ophthalmology : the Official Journal of the North American Neuro-Ophthalmology Society·Philippe Gailloud, Neil R Miller
Apr 28, 2012·Neurosurgical Focus·L Fernando GonzalezRobert H Rosenwasser
May 15, 2013·Journal of Neurosurgery·Alberto GilGregorio Rodríguez-Boto
Nov 24, 2011·Neurosurgery Clinics of North America·Neil R Miller
Nov 24, 2011·Neurosurgery Clinics of North America·Alexandra R PaulAlexander L Coon
Jan 7, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ruth ThiexAjith J Thomas
Feb 16, 2015·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Ryan P MortonBasavaraj V Ghodke
May 28, 2015·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Ming LvZhongxue Wu
May 1, 2012·Vascular and Endovascular Surgery·J A Santos-FrancoS Vega-Montesinos
Nov 22, 2017·Journal of Cerebrovascular and Endovascular Neurosurgery·Jong Min LeeJong Wook Choi
Apr 5, 2017·The Neuroradiology Journal·Carlos CastañoMikel Terceño
Sep 1, 2018·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Luís Henrique de Castro-AfonsoDaniel G Abud
Aug 11, 2016·Clinical Neuroradiology·Felipe Padovani TrivelatoMarco Túlio Salles Rezende
Dec 21, 2013·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·Gustavo AndradeHildo R C Azevedo-Filho

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