Embolization of Spontaneous Orbital Arteriovenous Fistula through a Thrombosed Superior Ophthalmic Vein: A Technical Report and Review of Relevant Literature

Neurographics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 241-246
Author(s):  
J. Khader Eliyas ◽  
A. Rubinov ◽  
M. Ashenhurst ◽  
A.P. Mitha ◽  
M. Eesa
Keyword(s):  
Literature Review ◽  
Arteriovenous Fistula ◽  
Relevant Literature ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Novel Approach ◽  
Technical Report ◽  
Vascular Connections ◽  
Arteries And Veins

Orbital AVFs, abnormal vascular connections between orbital arteries and veins, are extremely rare. Often traumatic, few reports of spontaneous orbital fistulas have been reported so far. Treatment is warranted for deteriorating visual symptoms, but obliteration of the fistula can be challenging. We present such a case that symptomatically mirrored a carotid cavernous fistula. A novel approach was used by traversing a thrombosed superior ophthalmic vein to embolize the lesion. In addition, a complete literature review is presented.

scholarly journals Endoscopic Endonasal Orbital Apex Decompression for Carotid Cavernous Fistula

2021 ◽  
pp. 014556132110303
Author(s):  
Noah Shaikh ◽  
Anthony Leonard ◽  
Caitlyn Patton ◽  
SoHyun Boo ◽  
John Nguyen ◽  
...  
Keyword(s):  
Complete Resolution ◽  
Standard Of Care ◽  
Endoscopic Endonasal Approach ◽  
Orbital Apex ◽  
Abducens Palsy ◽  
Carotid Cavernous Fistula ◽  
Endoscopic Endonasal ◽  
Cavernous Fistula ◽  
Novel Approach ◽  
Gaze Palsy

Significance Statement This case report demonstrates a novel approach to treating a rare indirect carotid cavernous fistula (CCF) and associated abducens palsy. Although endovascular treatment is the standard of care in the management of CCFs, it was contraindicated in this patient. Instead, she underwent an endoscopic endonasal approach (EEA) with decompression of the medial orbital apex, including the cavernous sinus and optic nerve, with complete resolution of headache, lateral gaze palsy, and diplopia within 2 months.

Electrothrombosis of carotid-cavernous fistula

1975 ◽  
Vol 42 (1) ◽  
pp. 76-85 ◽  
Author(s):  
Yoshio Hosobuchi
Keyword(s):  
Posterior Segment ◽  
Cerebral Vein ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Arterial Circulation ◽  
Inferior Portion ◽  
Pterygoid Plexus ◽  
Fine Print

✓ The author describes a technique for directly closing a carotid cavernous fistula with electrothrombosis while preserving the intracranial arterial circulation. Copper wires are introduced through the superior ophthalmic vein or a frontotemporal craniotomy, and thus directly into the portion of the sinus into which the fistula drains; if posterior, into the posterior segment of Parkinson's triangle, if inferior, into the pterygoid plexus, and if anterior, through the sphenoparietal sinus and/or middle cerebral vein to the anterior-inferior portion of the sinus. A direct current is applied until a thrombus is confirmed angiographically and the wires are left in place. Four patients treated by this method are presented.

scholarly journals Embolization of dural carotid cavernous fistula via the superior ophthalmic vein approach: a case report

2015 ◽  
Vol 14 (3) ◽  
pp. 118-123
Author(s):  
Nigel CS Lim ◽  
Hazel Anne Lin ◽  
Kok Kee Tang ◽  
Cheng Kang Ong ◽  
Gangadhara Sundar
Keyword(s):  
Case Report ◽  
Operating Theatre ◽  
Viable Alternative ◽  
Type B ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Close Cooperation ◽  
Cosmetic Outcomes

In this case report, we present a patient with Type B dural carotid-cavernous fistula (CCF), who had failed cannulation via the transfemoral route and subsequently underwent CCF occlusion via the anterior orbital approach through the superior ophthalmic vein (SOV). Successful occlusion of CCF was achieved, with excellent visual and cosmetic outcomes postoperatively. When all venous routes have been exhausted, the SOV approach is an excellent and viable alternative in the treatment of dural CCFs. Close cooperation between the orbital and neuro-interventional teams in a hybrid operating theatre setting is essential in ensuring success of the operation.

scholarly journals A novel approach to the treatment of a direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV

2014 ◽  
Vol 2014 (nov24 1) ◽  
pp. bcr2014011414-bcr2014011414 ◽  
Author(s):  
I. Nakagawa ◽  
H. S. Park ◽  
T. Wada ◽  
K. Takayama ◽  
H. Nakagawa ◽  
...  
Keyword(s):  
Syndrome Type ◽  
Carotid Cavernous Fistula ◽  
Ehlers Danlos Syndrome ◽  
Cavernous Fistula ◽  
Type Iv ◽  
Novel Approach ◽  
Danlos Syndrome ◽  
Direct Carotid Cavernous Fistula

scholarly journals Dural carotid cavernous fistula following hypertensive emergency

2019 ◽  
Vol 12 (9) ◽  
pp. e230823
Author(s):  
Geoffrey Law ◽  
Gavin Docherty
Keyword(s):  
Vision Loss ◽  
Venous Drainage ◽  
Hypertensive Emergency ◽  
Visual Recovery ◽  
Superior Ophthalmic Vein ◽  
Coil Embolisation ◽  
Carotid Cavernous Fistula ◽  
Cerebral Angiogram ◽  
Cavernous Fistula ◽  
Type D

A 58-year-old woman was referred to the outpatient ophthalmology clinic with progressive bilateral eye redness and vision loss. She had presented 2 weeks earlier with an episode of hypertensive emergency. CT angiography revealed bilateral superior ophthalmic vein (SOV) dilation, prompting further workup with a cerebral angiogram. Subsequent imaging revealed an indirect (type D) carotid-cavernous fistula (CCF) with venous drainage into both SOVs and cavernous sinuses. Successful treatment of the CCF with coil embolisation required interdisciplinary teamwork between ophthalmologists and interventional neuroradiologists. The patient made a substantial visual recovery following treatment.

Traumatic Ophthalmic Fistula Simulating Carotid-Cavernous Fistula

Neurosurgery ◽  
1983 ◽  
Vol 12 (1) ◽  
pp. 102-104 ◽  
Author(s):  
Miguel A. L. Freitas ◽  
Cyro A.B. Filho ◽  
Ranulfo Lima ◽  
Edson Marchiori
Keyword(s):  
Ophthalmic Artery ◽  
Carotid Angiography ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Spontaneous Thrombosis ◽  
Cavernous Fistula ◽  
Repeat Angiography ◽  
The Right

Abstract In a patient with a penetrating lesion of the right orbit with proptosis and a bruit in this region, carotid angiography revealed an ophthalmic fistula between the ophthalmic artery and the superior ophthalmic vein. Three days after admission, the symptoms disappeared, and repeat angiography showed the spontaneous thrombosis of the fistula.

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