Efficacy and safety of proximal spring coil occlusion of the ophthalmic vein in cavernous sinus-dural arteriovenous fistulae
10.3760/cma.j.cn115354-20230724-00019
- VernacularTitle:眼静脉近心端弹簧圈闭塞在海绵窦区硬脑膜动静脉瘘治疗中的疗效和安全性分析
- Author:
Zhuangzhuang WEI
1
;
Ji MA
;
Jie YANG
;
Ye WANG
;
Zhen LI
;
Jiajia CHEN
;
Wenzhan WANG
;
Xinwei HAN
;
Tengfei LI
Author Information
1. 郑州大学第一附属医院放射介入科，郑州大学介入治疗研究所，郑州 450052
- Keywords:
Dural arteriovenous fistula;
Ophthalmic vein;
Endovascular intervention;
Spring coil;
Onyx Gel
- From:
Chinese Journal of Neuromedicine
2023;22(10):1010-1015
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy and safety of intracavernous sinus spring coil+Onyx gel embolization combined with proximal spring coil occlusion of the ophthalmic vein in cavernous sinus-dural arteriovenous fistula (CS-DAVF).Methods:Thirty-seven patients with CS-DAVF accepted intracavernous sinus spring coil+Onyx gel embolization combined with proximal spring coil occlusion of ophthalmic vein in Department of Radiology and Interventional Medicine, First Affiliated Hospital of Zhengzhou University were selected. The clinical data and therapeutic efficacy of these patients were retrospectively analyzed.Results:All 37 patients had different degrees of ocular symptoms at the time of treatment: 31 (83.8 %) had conjunctival congestion, 16 (43.2 %) had exophthalmos, and 14 (37.8 %) had obvious periorbital vascular murmur. Endovascular intervention was performed in all patients via venous routes, including inferior petrous sinus approach ( n=34), ophthalmic vein approach ( n=2), and facial vein approach ( n=1). Immediate postoperative DSA showed that 31 patients had complete occlusion of the fistula, and 6 patients had near-total occlusion (disappeared drainage of the thickened ophthalmic vein or obviously slowed down drainage). Thirty-five patients had ocular oedema of varied degrees and then gradually reduced (lasting for 1-2 weeks), and all the ocular congestion and vascular murmurs disappeared before discharging from the hospital. Four patients had postoperative palsy of the motor and abducens nerves, which improved significantly after 1-5 months; 1 patient had diplopia in combination with abducens nerve palsy; all symptoms alleviated after 2 months of nutritional nerve medication. Follow up in Outpatient Clinic or telephone was performed for (12.1±4.4) months, ranged for 6.5-21.3 months; symptoms of ocular congestion and edema disappeared in all patients at the last follow-up. Followed-up DSA at 6 months showed no recurrence of CS-DAVF. Conclusion:Intracavernous sinus spring coil+Onyx gel embolisation combined with proximal spring coil occlusion of the ophthalmic vein is safe and effective in CS-DAVF.
