Cavernous sinus fistula treated through the transvenous approach: Report of four cases

Fan, Bing; Albrieux, Magali; Moreau-Gaudry, V Vinh; Vasdev, A

doi:10.1016/j.neurad.2009.01.002

Cited by 12 publications

(13 citation statements)

References 31 publications

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“…The paradoxical worsening of signs result from SOV thrombosis may cause OCS, as suggested in a previous report. [ 2 , 5 ] We did not perform an angiogram to confirm this supposition because an imaging evaluation would have delayed the OCS intervention. [ 3 ] The natural history following SOV thrombosis as seen in previously reported cases is subsequent spontaneous resolution when collateral vessels develop to drainage the venous outflow.…”

Section: Discussionmentioning

confidence: 99%

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Amelioration of acute orbital compartment syndrome following transvenous embolization for an indirect carotid-cavernous fistula

Hsieh

Weng²,

Tai³

et al. 2017

Medicine

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Rationale:Orbital compartment syndrome (OCS) is a rare occurrence after transvenous embolization of indirect carotid-cavernous fistula (CCF). A lateral canthotomy and cantholysis are the most commonly performed surgical interventions. In our case, as the acute OCS occurred immediately after an uneventful transvenous embolization, an orbital floor orbitectomy was performed.Patient concerns:Here, we present a rare case of a 59-year-old patient who required a transvenous embolization of an indirect CCF and subsequently immediately developed an acute OCS.Diagnoses:An indirect CCF was revealed using brain magnetic resonance angiography and a transvenous embolization of the fistula was performed using coils. Post-embolization angiograms revealed an occlusion of the CCF.Interventions:After the development of a relative afferent pupillary defect and acute OCS, we performed a lateral canthotomy, superior and inferior cantholysis, and an orbital floor orbitectomy. Subsequently, visual acuity and intraocular pressure improved.Lessons:Our case is the first report of acute OCS occurring after transvenous embolization of a CCF that required further orbital floor decompression to prevent permanent visual loss. Moreover, our case demonstrates that acute OCS may rapidly develop after transvenous embolization due to superior ophthalmic venous (SOV) thrombosis and that an early intervention may reduce the risk of visual impairment.

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Section: Discussionmentioning

confidence: 99%

“…[ 2 ] The present case may serve as a reminder to radiologists and neurosurgeons that an OCS can progress rapidly and complete cavernous sinus occlusion should be avoided as suggested in the previous report. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

Amelioration of acute orbital compartment syndrome following transvenous embolization for an indirect carotid-cavernous fistula

Hsieh

Weng²,

Tai³

et al. 2017

Medicine

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“…Because the contralateral ICA had been occluded, it was considered safer to use a venous approach when attempting CCF occlusion in this patient. [9][10][11] The transvenous approach eliminates or decreases the risk of vascular injury, but could be hindered by the trabeculae of the cavernous sinus. 12 Without ICA occlusion, transarterial access should be first selected.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Bilateral Multiple Carotid-Cavernous Fistulas in a Patient with Ehlers-Danlos Syndrome

Wang

Chen

2012

J Neurol Surg A Cent Eur Neurosurg

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“…Transvenous embolization, on the other hand, has been accepted as the preferred treatment for CCF. [ 10 – 13 ] The transvenous route usually involves a retrograde or posterior path through the IJV, and the IPS up to the cavernous sinus. [ 11 13 ] According to one article, the IPS route is the most direct approach and relatively safe,[ 13 ] but excessively tight packing of CCF can result in transient oculomotor or abducens nerve palsy and occlusion of the ICA.…”

Section: Discussionmentioning

confidence: 99%

Transvenous embolization in spontaneous direct carotid-cavernous fistula in childhood

et al. 2011

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Carotid cavernous fistula (CCF) is an abnormal arteriovenous communication in the cavernous sinus. Direct CCF results from a tear in the intracavernous carotid artery. Typically, it has a high flow and usually presents with oculo-orbital venous congestive features such as exophthalmos, chemosis, and sometimes oculomotor or abducens cranial nerve palsy. Indirect CCF generally occurs spontaneously with subtle signs. We report a rare case of spontaneous direct CCF in childhood who did not have the usual history of craniofacial trauma or connective tissue disorder but presented with progressive chemosis and exophthalmos of the right eye. This report aims also to describe the safety and success of transvenous embolization with coils of the superior ophthalmic vein and cavernous sinus through the inferior petrosal sinus.

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Cavernous sinus fistula treated through the transvenous approach: Report of four cases

Cited by 12 publications

References 31 publications

Amelioration of acute orbital compartment syndrome following transvenous embolization for an indirect carotid-cavernous fistula

Amelioration of acute orbital compartment syndrome following transvenous embolization for an indirect carotid-cavernous fistula

Endovascular Treatment of Bilateral Multiple Carotid-Cavernous Fistulas in a Patient with Ehlers-Danlos Syndrome

Transvenous embolization in spontaneous direct carotid-cavernous fistula in childhood

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