scholarly journals Cavernous Sinus Dural Fistula Treated by Transvenous Facial Vein Approach

2004 ◽  
Vol 10 (1) ◽  
pp. 69-74 ◽  
Author(s):  
V. Prochazka ◽  
V. Cizek ◽  
R. Kacirova
Keyword(s):  
Cavernous Sinus ◽  
Treatment Approach ◽  
Inferior Petrosal Sinus ◽  
Digital Angiography ◽  
Venous Outflow ◽  
Type D ◽  
Facial Vein ◽  
Embolization Treatment ◽  
Catheter Navigation ◽  
Fistula Site

We report on the endovascular treatment of the spontaneous indirect dural carotid cavernous sinus type D fistula in a 60-year-old woman, in whom ipsilateral facial, angular and superior ophthalmic veins catheterization was performed to get access to the fistula site for embolization treatment. Approach via the facial vein is helpful after inferior petrosal sinus treatment failure. Although this technique requires caution in the angular vein region it allows a safe and effective treatment of these lesions. 3D rotational digital angiography can obtain more information of the angioarchitecture of the cavernous plexus and venous outflow for the catheter navigation.

scholarly journals Cavernous sinus dural arteriovenous fistula treated by facial vein direct puncture: Case report and review of the literature

2017 ◽  
Vol 23 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Atsushi Matsumoto ◽  
Masanobu Okauchi ◽  
Atsushi Shindo ◽  
Masahiko Kawanishi ◽  
Takashi Tamiya
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Inferior Petrosal Sinus ◽  
Digital Subtraction ◽  
Transvenous Embolization ◽  
Review Of The Literature ◽  
Direct Puncture ◽  
Facial Vein

Introduction In case of cavernous sinus dural arteriovenous fistula (CSDAVF), transvenous embolization (TVE) of the cavernous sinus (CS) via the inferior petrosal sinus (IPS) is generally performed. However, various approach routes have been reported when the accessibility of the IPS is challenging. We herein report a case of CSDAVF treated by TVE with direct puncture of the facial vein. Case report A 70-year-old woman who suffered from tinnitus, chemosis, diplopia and bruit was referred to our hospital. Digital subtraction angiography (DSA) demonstrated CSDAVF. We initially attempted to perform TVE via the IPS route; however, we could not guide a catheter to the CS because of an anatomical difficulty. Then, we performed percutaneous direct puncture of the dilated facial vein, and successfully treated the patient. Conclusion When navigating microcatheter to the CS is difficult because of an anatomical difficulty of the IPS, direct puncture of the facial vein is a feasible route.

scholarly journals Spontaneous Isolated Dural Arteriovenous Fistula of the Cavernous Sinus: Endovascular Approach via the Foramen Ovale

2012 ◽  
Vol 18 (4) ◽  
pp. 458-462 ◽  
Author(s):  
G. Cabral de Andrade ◽  
H.P. Alves ◽  
R. Parente ◽  
C.P. Salvarani ◽  
V.M. Clímaco ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Inferior Petrosal Sinus ◽  
Foramen Ovale ◽  
Superior Ophthalmic Vein ◽  
Conjunctival Hyperemia ◽  
Emissary Vein ◽  
Direct Puncture ◽  
Facial Vein

The endovascular treatment of spontaneous dural cavernous sinus fistula (DAVF) can be accomplished by arterial approach, just with symptoms relief, or by numerous venous approaches through the inferior petrosal sinus, ophthalmic vein, anterior or posterior intercavernous sinus and facial vein. Our case suggests the approach to the cavernous sinus via the foramen ovale and emissary veins puncture as an alternative when there is no possibility of venous approach conventionally described. A 76-year-old woman presented with right conjunctival hyperemia, exophthalmos, intraocular pressure increasing and visual deficits in a period of six months. Angiographic diagnosis of spontaneous DAVF isolated from the cavernous sinus, Barrow Type C, with exclusive venous drainage through the superior ophthalmic vein. Endovascular treatment was performed under general anesthesia. Attempts to approach the cavernous sinus through the inferior petrosal sinus ipsilateral and contralateral intercavernous, facial vein and pterygoid plexus, as well as by dissection and direct puncture of the superior ophthalmic vein were not possible. An approach to the cavernous sinus was performed by puncturing the foramen ovale, catheterization of the emissary vein of the foramen ovale with occlusion of the fistula with microcoils. There was a symptomatic regression with gradual normalization of intraocular pressure, exophthalmos and conjunctival hyperemia in three months. The approach to the cavernous sinus through the foramen ovale and catheterization of the emissary cranial skull base vein is an exception and should be considered in cases of spontaneous and isolated DAVF not accessible by a conventional approach.

Pitfalls in Endovascular Treatment of Dural Arteriovenous Fistulas Involving the Cavernous Sinus

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 88-92
Author(s):  
N. Kuwayama ◽  
S. Endo ◽  
M. Kubo ◽  
T. Akai ◽  
A. Takaku
Keyword(s):  
Endovascular Treatment ◽  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Transarterial Embolization ◽  
Abducens Nerve ◽  
Abducens Nerve Palsy ◽  
Arteriovenous Fistulas ◽  
Type D ◽  
Dural Arteriovenous Fistulas ◽  
The Right

Angiographic changes of the sylvian veins, superior ophthalmic vein (SOV), and superior petrosal sinus (SPS) before and after endovascular treatment were determined for 18 patients with dural arteriovenous fistulas (AVFs) involving the cavernous sinus, and pitfalls of endovascular treatment, especially regarding venous drainage routes, for 3 of the patients were reported. Case 1: 57-year-old woman who presented with right abducens nerve palsy had a Barrow type D fistula in the right cavernous sinus draining into the bilateral inferior petrosal sinuses (IPS). One of the ipsilateral sylvian veins that had drained antegradely before treatment was occluded, and a small lacunar infarction in the corona radiata developed after transvenous embolization (TVE) of the right cavernous sinus. Case 2: 72-year-old woman who presented with symptoms of right ocular hypertension had a type D fistula in the right cavernous sinus draining into only the ipsilateral SOV. Conjunctival hyperemia persisted and was aggravated after angioanatomical obliteration of the fistula by transarterial embolization. Case 3: 55-year-old man who presented with left abducens nerve palsy had a type D fistula in the left cavernous sinus draining into the ipsilateral IPS and sylvian vein. The dural AVF was obliterated once with TVE, but recurred 1 week later with retrograde drainage into the ipsilateral SPS and mesencephalic veins. A second TVE resulted in complete obliteration of the fistula. In conclusion, detailed analysis of drainage routes is necessary for planning of treatment of patients with dural AVF, and prompt treatment is needed when redistribution of drainage routes develops during or after TVE.

scholarly journals Lateralization of inferior petrosal sinus sampling in Cushing's disease correlates with cavernous sinus venous drainage patterns, but not tumor lateralization

Heliyon ◽  
2020 ◽  
Vol 6 (10) ◽  
pp. e05299
Author(s):  
Mohammad Ghorbani ◽  
Hamideh Akbari ◽  
Christoph J. Griessenauer ◽  
Christoph Wipplinger ◽  
Alireza Dastmalchi ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Cushing’S Disease ◽  
Venous Drainage ◽  
Cushing's Disease ◽  
Inferior Petrosal Sinus ◽  
Inferior Petrosal Sinus Sampling ◽  
Drainage Patterns

Selective transvenous embolization of dural carotid—cavernous sinus fistulas with preservation of sylvian venous outflow

1998 ◽  
Vol 89 (5) ◽  
pp. 825-829 ◽  
Author(s):  
Mitsugu Nakamura ◽  
Norihiko Tamaki ◽  
Tetsuro Kawaguchi ◽  
Shigekiyo Fujita
Keyword(s):  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Transarterial Embolization ◽  
Venous Drainage ◽  
The Other ◽  
Oculomotor Nerve Palsy ◽  
Transvenous Embolization ◽  
Venous Outflow ◽  
Residual Shunt ◽  
Abducent Nerve Palsy

✓ A transvenous embolization technique in which normal cerebral venous drainage can be spared is described. Of 26 dural carotid—cavernous fistulas treated by the authors, the affected cavernous sinus received not only the shunted flow but also the sylvian venous drainage in three cases. Two patients presented with an abducent nerve palsy, and one with an oculomotor nerve palsy. Selective transvenous embolization of the fistulous portions of the affected cavernous sinus was achieved, with preservation of the sylvian venous outflow. Postembolization angiograms revealed complete occlusion of the fistula in one patient and only a small amount of residual shunt in the other two. One of these two underwent subsequent transarterial embolization, and the other was followed without additional treatment. The patients' symptoms resolved between 1 and 2 months posttreatment. Follow-up angiograms revealed that the remnant shunt had disappeared and the sylvian venous pathway had been preserved. The authors conclude that selective transvenous embolization of fistulous compartments in an affected sinus can be used to treat dural arteriovenous fistulas involving a cavernous sinus that also receives the sylvian venous outflow.

scholarly journals An algorithm to improve lateralization accuracy of inferior petrosal sinus sampling: procedural nuances for complex patterns of venous drainage. Patient series

2021 ◽  
Vol 2 (13) ◽  
Author(s):  
Abhijith V. Matur ◽  
Alaina M. Body ◽  
Mark D. Johnson ◽  
Matthew S. Smith ◽  
Ruchi Bhabhra ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Imaging Finding ◽  
Case Series ◽  
Optimal Sampling ◽  
Inferior Petrosal Sinus ◽  
Retrospective Case ◽  
Inferior Petrosal Sinus Sampling ◽  
Drainage Patterns ◽  
Sinus Drainage ◽  
Tumor Laterality

BACKGROUND Inferior petrosal sinus sampling (IPSS) is a useful technique in the diagnosis of Cushing’s disease (CD) when the imaging finding is negative or equivocal. Different authors have reported considerable variability in the ability to determine tumor laterality with IPSS. Here the authors present a retrospective case series of 7 patients who underwent IPSS using a systematic algorithm to improve lateralization accuracy by identifying optimal sampling sites on the basis of individual cavernous sinus drainage patterns in each patient. OBSERVATIONS Of the 7 patients identified, 6 were determined to have CD and subsequently underwent surgery. IPSS was accurate in all patients from whom laterality was predicted. Arterial and venous angiography were used to define cavernous sinus drainage patterns and determine optimal sampling sites. All patients who underwent surgery achieved hormonal cure. LESSONS All IPSS predictions of lateralization were correct when available, and all patients who underwent surgery achieved hormonal cure. Advances in angiographic techniques for identification of the site of primary drainage from the cavernous sinus and subsequent optimization of microcatheter placement may improve the ability to predict tumor laterality.

scholarly journals Cavernous Sinus Dural Arteriovenous Fistula Unresponsive to Transvenous Embolization Via the Inferior Petrosal Sinus

2005 ◽  
Vol 33 (3) ◽  
pp. 180-186
Author(s):  
Masato OHKI ◽  
Takamasa KAYAMA ◽  
Yasuaki KOKUBO ◽  
Shinjiro SAITO ◽  
Rei KONDO ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Dural Arteriovenous Fistula ◽  
Inferior Petrosal Sinus ◽  
Transvenous Embolization
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