Abstract
Introduction: Percutaneous transvenous embolization (TVE) using coils is a well-established treatment of cavernous sinus dural arteriovenous fistula (CSdAVF). However, it is sometimes difficult to achieve complete occlusion by coil embolization. In these two cases, we were able to obtain complete angiographic obliteration of the fistulas without complications by means of percutaneous TVE using n-butyl-cyanoacrylate (NBCA) after we failed when TVE using coils. Case 1: An 89-year-old woman presented with double vision. She was diagnosed as Barrow type D right CSdAVF draining only to the cortical vein. We treated the patient by TVE using coils, but the microcatheter was withdrawn before complete occlusion was attained. The repositioning of the microcatheter was difficult, so we used 30% NBCA for TVE, and obtained complete obliteration of the fistula. Case 2: An 87-year-old woman presented with right exophthalmos, and chemosis. She was diagnosed as Barrow type C right CSdAVF draining only to the right superior ophthalmic vein with very slow flow. We planned to treat her, using TVE with coils, but we could place only 3 coils and obtained only partial obliteration of the fistula. So we additionally used 25% NBCA for TVE, and obtained complete obliteration of the fistula. Conclusion: Compared to TVE using coils, TVE using NBCA gives rise to many problems, but, we can use NBCA as a second option if TVE using coils results in only partial obliteration as in these cases.
| Original language | English |
|---|---|
| Pages (from-to) | 1189-1196 |
| Number of pages | 8 |
| Journal | Neurological Surgery |
| Volume | 39 |
| Issue number | 12 |
| Publication status | Published - Dec 10 2011 |
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Keywords
- Cavernous sinus dural arteriovenous fistula
- NBCA
- Retrograde cortical venous reflux
- Transvenous embolization
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Cavernous sinus dural arteriovenous fistulas treated with percutaneous transvenous embolization using liquid material : Two case reports. / Hiramatsu, Masafumi; Sugiu, Kenji; Tokunaga, Koji; Nishida, Ayumi; Kuriyama, Mitsuo; Maeshiro, Tomohide; Terasaka, Kaoru; Date, Isao.
In: Neurological Surgery, Vol. 39, No. 12, 10.12.2011, p. 1189-1196.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cavernous sinus dural arteriovenous fistulas treated with percutaneous transvenous embolization using liquid material
T2 - Two case reports
AU - Hiramatsu, Masafumi
AU - Sugiu, Kenji
AU - Tokunaga, Koji
AU - Nishida, Ayumi
AU - Kuriyama, Mitsuo
AU - Maeshiro, Tomohide
AU - Terasaka, Kaoru
AU - Date, Isao
PY - 2011/12/10
Y1 - 2011/12/10
N2 - Introduction: Percutaneous transvenous embolization (TVE) using coils is a well-established treatment of cavernous sinus dural arteriovenous fistula (CSdAVF). However, it is sometimes difficult to achieve complete occlusion by coil embolization. In these two cases, we were able to obtain complete angiographic obliteration of the fistulas without complications by means of percutaneous TVE using n-butyl-cyanoacrylate (NBCA) after we failed when TVE using coils. Case 1: An 89-year-old woman presented with double vision. She was diagnosed as Barrow type D right CSdAVF draining only to the cortical vein. We treated the patient by TVE using coils, but the microcatheter was withdrawn before complete occlusion was attained. The repositioning of the microcatheter was difficult, so we used 30% NBCA for TVE, and obtained complete obliteration of the fistula. Case 2: An 87-year-old woman presented with right exophthalmos, and chemosis. She was diagnosed as Barrow type C right CSdAVF draining only to the right superior ophthalmic vein with very slow flow. We planned to treat her, using TVE with coils, but we could place only 3 coils and obtained only partial obliteration of the fistula. So we additionally used 25% NBCA for TVE, and obtained complete obliteration of the fistula. Conclusion: Compared to TVE using coils, TVE using NBCA gives rise to many problems, but, we can use NBCA as a second option if TVE using coils results in only partial obliteration as in these cases.
AB - Introduction: Percutaneous transvenous embolization (TVE) using coils is a well-established treatment of cavernous sinus dural arteriovenous fistula (CSdAVF). However, it is sometimes difficult to achieve complete occlusion by coil embolization. In these two cases, we were able to obtain complete angiographic obliteration of the fistulas without complications by means of percutaneous TVE using n-butyl-cyanoacrylate (NBCA) after we failed when TVE using coils. Case 1: An 89-year-old woman presented with double vision. She was diagnosed as Barrow type D right CSdAVF draining only to the cortical vein. We treated the patient by TVE using coils, but the microcatheter was withdrawn before complete occlusion was attained. The repositioning of the microcatheter was difficult, so we used 30% NBCA for TVE, and obtained complete obliteration of the fistula. Case 2: An 87-year-old woman presented with right exophthalmos, and chemosis. She was diagnosed as Barrow type C right CSdAVF draining only to the right superior ophthalmic vein with very slow flow. We planned to treat her, using TVE with coils, but we could place only 3 coils and obtained only partial obliteration of the fistula. So we additionally used 25% NBCA for TVE, and obtained complete obliteration of the fistula. Conclusion: Compared to TVE using coils, TVE using NBCA gives rise to many problems, but, we can use NBCA as a second option if TVE using coils results in only partial obliteration as in these cases.
KW - Cavernous sinus dural arteriovenous fistula
KW - NBCA
KW - Retrograde cortical venous reflux
KW - Transvenous embolization
UR - http://www.scopus.com/inward/record.url?scp=84455171524&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84455171524&partnerID=8YFLogxK
M3 - Article
C2 - 22128275
AN - SCOPUS:84455171524
VL - 39
SP - 1189
EP - 1196
JO - Neurological Surgery
JF - Neurological Surgery
SN - 0301-2603
IS - 12
ER -