RT Journal Article
SR Electronic
T1 Imaging-Guided Superior Ophthalmic Vein Access for Embolization of Dural Carotid Cavernous Fistulas: Report of 20 Cases and Review of the Literature
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 699
OP 702
DO 10.3174/ajnr.A5994
VO 40
IS 4
A1 M.K.S. Heran
A1 D. Volders
A1 C. Haw
A1 J.R. Shewchuk
YR 2019
UL http://www.ajnr.org/content/40/4/699.abstract
AB SUMMARY: Dural carotid cavernous fistulas are usually treated via a transvenous approach through the inferior petrosal sinus. Surgical exposure and direct access to the superior ophthalmic vein have been previously described in situations in which conventional transvenous access, including the inferior petrosal sinus, is not possible. In this retrospective study of 20 patients, we report our results of imaging-guided percutaneous superior ophthalmic vein access in dural carotid cavernous fistula treatment. The superior ophthalmic vein was accessed after direct percutaneous puncture under sonographic guidance in 16 patients and biplane roadmap guidance in 4 patients. In all 20 patients, it was possible to access the superior ophthalmic vein and cure the dural carotid cavernous fistula. Two patients developed a retrobulbar hematoma after postseptal puncture, which required emergency lateral canthothomy. In our experience, direct imaging-guided percutaneous superior ophthalmic vein access is a safe alternative approach for treatment in situations in which conventional transvenous approaches are not possible.dCCFdural carotid cavernous fistulaIPSinferior petrosal sinusSOVsuperior ophthalmic vein