A Case of Venous Anomaly of Diploic Origin Successfully Treated by Preoperative Direct Puncture Sclerotherapy

Abstract

Objective: One case of venous anomaly arising from the cranium in which intraoperative hemorrhage could be effectively controlled by direct puncture sclerotherapy using N-butyl-2-cyanoacrylate (NBCA) is reported.Case Presentation: A 76-year-old male noted gradually progressing right exophthalmos and swelling of the right temporal region and was found by imaging studies to have a space-occupying lesion extending inside and outside the cranium and in the orbit. On diagnostic biopsy of the extracranial part under local anesthesia, massive and spouting venous hemorrhage was observed. From intraoperative and pathological findings, a diagnosis of venous anomaly was made, and sclerotherapy was performed using NBCA under direct percutaneous puncture. After 4 days, the lesion could be resected totally with only slight bleeding. Conclusion:Sclerotherapy using NBCA by direct puncture is considered useful as a preoperative treatment for venous anomalies.Keywords▶ venous anomaly, N-butyl-2-cyanoacrylate, direct puncture, sclerotherapy Case PresentationThe patient was a 76-year-old male who complained of exophthalmos of the right eye and swelling of the right

Head and Neck Arteriovenous Malformations: Clinical Manifestations and Endovascular Treatments

“…It requires flushing of the microcatheter with 5% dextrose and rapid removal when reflux of the material to the catheter tip is observed to avoid catheter entrapment. Furthermore, NBCA is thought to exhibit high thrombogenicity compared with another liquid embolic material, ethylene vinyl alcohol (EVOH); thus, progressive and permanent occlusion can be achieved owing to this property [58].…”