Transvenous embolization of dural carotid cavernous fistulas: the role of liquid embolic agents in association with coils on patient outcomes

Castro-Afonso, Luís Henrique de; Trivelato, Felipe Padovani; Rezende, Marco Túlio Salles; Ulhôa, Alexandre Cordeiro; Nakiri, Guilherme Seizem; Monsignore, Lucas Moretti; Colli, Benedicto Oscar; Velasco-e-Cruz, Antônio Augusto; Abud, Daniel Giansante

doi:10.1136/neurintsurg-2017-013318

Cited by 29 publications

(39 citation statements)

References 30 publications

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“…Although recent studies reported higher dCCF occlusion rates with liquid embolic materials than with coils alone and durable mid- and long-term results, treatment with liquid embolic agent may result in the occlusion of arterial collaterals and cause cranial nerve ischemia 3)7)8). In this case, we did not use any embolic materials to achieve complete occlusion because small feeders from the branches of the internal carotid artery may be compromised.…”

Section: Discussionmentioning

confidence: 91%

Transvenous Embolization of Dural Carotid Cavernous Fistula through the Supraorbital Vein

Han

Kim

Kang

et al. 1970

J Cerebrovasc Endovasc Neurosurg

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We describe a case of transvenous embolization through the dilated supraorbital vein to treat a dural carotid cavernous fistula. The approach through the common facial vein or direct access of the superior ophthalmic vein is a commonly used route to the superior ophthalmic vein when the approach via the inferior petrosal sinus is unavailable. In rare cases, the dilated supraorbital vein provides an alternative route and we discuss the technical details.

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Section: Discussionmentioning

confidence: 91%

Transvenous Embolization of Dural Carotid Cavernous Fistula through the Supraorbital Vein

Han

Kim

Kang

et al. 1970

J Cerebrovasc Endovasc Neurosurg

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“…Embolization can be done with coils, liquid embolic agents, or a combination of the two, with cure rates around 85% and low morbidity and mortality. We chose to inject Histoacryl® instead of Onyx® inside the superior ophthalmic vein to avoid creating a mass effect, a complication related when using this last embolic agent [18].…”

Section: Discussionmentioning

confidence: 99%

Successful Endovascular Treatment of Trigeminal Neuralgia Caused by a CarotidCavernous Fistula: Case Report

Manzato¹,

Filho²,

Karam³

et al. 2020

SCR

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Dural arteriovenous fistulas (DAVFs) of the cavernous sinus are arteriovenous connections located in the dura mater leaflets of this region. The usual presentation of a DAVF is predominantly ocular, with symptoms such as diplopia, conjunctival injection, involvement of cranial nerves III/IV/VI, exophthalmos, and chemosis. Trigeminal neuralgia caused by a cavernous DAVF is extremely rare. To the best our knowledge, this is only the fourth report in the world literature. We describe the case of a patient treated by embolization in whom the only presenting symptom of DAVF was trigeminal neuralgia. After endovascular treatment, the patient became asymptomatic.

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“…Onyx embolization is less controlled than coil placement, however, this material is associated with a higher rate of complete obliteration [9]. Furthermore, because Onyx is less thrombogen-ic than coils, paradoxical worsening occurs less frequently after Onyx embolization.…”

Section: Discussionmentioning

confidence: 99%

“…The formation of an Onyx plug in the CS is challenging, given the shunted flow and high pressure. Thus, in previous reports, coils were inserted before injecting Onyx to act as a template for the material [5,9,15].…”

Section: Discussionmentioning

confidence: 99%

Transvenous Onyx embolization of cavernous sinus dural arteriovenous fistula using a balloon catheter in the arterial side for flow control

et al. 2019

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Background: Cavernous sinus (CS) dural arteriovenous fistulas (DAVFs) are abnormal arteriovenous shunts involving the dura mater, located within or near the walls of the CS. Transvenous embolization is considered to be an effective treatment for CS DAVF. We describe a novel technique for the use of transvenous Onyx embolization in the treatment of CS DAVF, which uses a temporary balloon to occlude the arterial side for flow control. Case Report: A 63-year-old woman presented with ocular pain and ptosis of the left eye. Cerebral angiography showed a left CS DAVF fed by multiple branches of the left external carotid artery. We successfully treated the CS DAVF using transvenous Onyx embolization with temporary balloon occlusion of the proximal feeding artery to decrease the shunted flow. Conclusion: Transvenous Onyx embolization with flow control via temporary balloon occlusion may be a useful technique for the embolization of CS DAVFs with multiple arterial feeders.

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Transvenous embolization of dural carotid cavernous fistulas: the role of liquid embolic agents in association with coils on patient outcomes

Cited by 29 publications

References 30 publications

Transvenous Embolization of Dural Carotid Cavernous Fistula through the Supraorbital Vein

Transvenous Embolization of Dural Carotid Cavernous Fistula through the Supraorbital Vein

Successful Endovascular Treatment of Trigeminal Neuralgia Caused by a CarotidCavernous Fistula: Case Report

Transvenous Onyx embolization of cavernous sinus dural arteriovenous fistula using a balloon catheter in the arterial side for flow control

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