Transvenous embolization of dural carotid-cavernous sinus fistulas with detachable coils and N-butyl cyanoacrylate
10.3760/cma.j.issn.1671-8925.2008.10.016
- VernacularTitle:经静脉途径应用可脱弹簧圈和n-BCA胶栓塞治疗硬脑膜海绵窦瘘
- Author:
Zheng-Ran LI
1
;
Jie-Sheng QIAN
;
Zai-Bo JIANG
;
Ming-Sheng HUANG
;
Kang-Shun ZHU
;
Shou-Hai GUAN
;
Peng-Fei PANG
;
Hong SHAN
Author Information
1. 中山大学附属第三医院
- Keywords:
Dural carotid-cavernous fistula;
Trausvenous;
Embolization
- From:
Chinese Journal of Neuromedicine
2008;7(10):1036-1040,1043
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the clinical outcome of transvenous embolization withdetachable coils and N-butyl cyanoacrylate (n-BCA) for management of dural carotid-cavernous sinusfistulas (dCCFs). Methods Six patients with angiographically confirmed spontaneous dCCF wereinvolved in this study, including two with concurrent ipsilateral internal jugular vein occlusion. All thepatients received surgeries for transvenous embolization through the superior ophthalmic vein (2 cases) orthe inferior petrosal sinus (4 cases), using detachable coils (2 cases) or detachable coils combined withn-BCA (4 cases). Results The vascular murmur, exophthalmos and conjunctival congestiondisappeared in 4 patients shortly after the total embolization of the fistulas, while eyeball movementdisorder, diplopia and visual deterioration persisted for at least 1 month and gradually recovered 3 monthsafter the surgery. The fistulas failed to be completely embolized in two patients, and in one of the patients,the symptoms resolved after intermittent carotid artery compression for one week; in the other patient,exophthalmos recurred and worsened 1 month after embolization, and was successfully managed withtransarteriai embolization of the fistula. No symptomatic complications were found in these 6 patientsafter transvenous embolization in spite of the presence of a few small n-BCA granules in the lungs of twopatients. Conclusion Transvenous embolization is safe and effective for management of dCCF, andcombined use of detachable coils and n-BCA may enhance the success rate of total fistula embolization.
