Endovascular embolotherapy treatment of carotid cavernous fistulas via superior ophthalmic vein / 中国综合临床

ABSTRACT

Objective To evaluate the effect of endovascular embolotherapy treatment of carotid cavernous fistulas(CCF) via superior ophthalmic vein(SOV).Methods From June 1996 to June 2006,a total of 32 patients(16 female) with complex CCF underwent endovascular embolotherapy treatment through the SOV.All of the patients visited doctor due to ocular signs and symptoms.Nine patients with direct CCF had previously undergone partial arterial balloons embolotherapy.The other 23 patients were hard mater CCF,and of which 3 had underwent NBCA,embolotherapy with line section or PVA particle.In the angiographic suite all patients underwent general anesthesia,SOV was catheterized through the eyebrow incision.Cavernous sinus was packed with free coils,detachable coils or balloons and NBCA.Results Complete embolism of the arteriovenous shunt was achieved in 81.3%(26/32).A minor residual shunt(without cortical or ocular drainage) remained in 12.5%(4/32).Only SOV was occluded in 6.2%(2/32).All patients were clinical improvement without complications.No death and permanent disability occurred.No recurrence was observed during follow-up of mean time of 3.5 years in 22 outpatients.Conclusion The operative approach to SOV is straightforward and several kind of embolic materials can be used to embolize the cavernous sinus.Endovascular occlusion of cavernous sinus through the SOV is an efficient and safe treatment in CCF.