Transvenous embolization of indirect carotid-cavernous fistula via puncture of the cubital vein and distal radial artery.

Carotid-cavernous fistula (CCF) is a pathologic communication between carotid arteries and cavernous sinus. The goal of endovascular treatment is to completely interrupt the carotid-cavernous communication with preserving normal blood flow in carotid arteries. Embolization can be performed via transarterial or transvenous access depending on anatomy and angioarchitecture of fistula. In this report, we present a 64-year-old woman with indirect CCF. Effective and safe embolization of indirect CCF was performed using distal radial access for diagnosis and navigation and cubital vein for simultaneous venous access for therapeutic endovascular manipulations, completely avoiding femoral access.

Retrograde transvenous balloon-assisted Onyx embolization of mandibular arteriovenous malformation after hemorrhage.

Mandibular arteriovenous malformation (AVM) is a rare lesion, but it often can be presented with life-threatening bleedings. Endovascular treatment of mandibular AVMs has multiple approaches including transarterial embolization, transvenous embolization, direct puncture, and sclerotherapy. In this case study, we present a patient with mandibular AVM complicated by hemorrhage. The patient was treated with transarterial embolization, followed by transvenous sclerotherapy with balloon occlusion of venous outflow. But radical occlusion of AVM was achieved only by transvenous embolization of AVM with Onyx via double lumen balloon, which occluded the venous outflow.