Coil Embolization Via a Superior Ophthalmic Vein Approach of Carotid Cavernous Sinus Fistula.
- Author:
Nam Kee LIM
1
;
Jae Kyong KIM
;
Eon Jeong KIM
;
Ji Myong YOO
Author Information
1. Department of Ophthalmology, Gyeongsang National University College of Medicine, Chinju, Korea. yjm@nongae.ac.kr
- Publication Type:Case Report
- Keywords:
Carotid cavernous sinus fistula;
Coil embolization;
Superior ophthalmic vein approach
- MeSH:
Aged;
Brain;
Carotid-Cavernous Sinus Fistula*;
Cautery;
Cerebral Angiography;
Diplopia;
Embolization, Therapeutic*;
Female;
Fistula;
Headache;
Humans;
Magnetic Resonance Imaging;
Orbit;
Punctures;
Tomography, X-Ray Computed;
Veins*
- From:Journal of the Korean Ophthalmological Society
2006;47(7):1141-1148
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The result of embolization via an external superior ophthalmic vein approach of carotid cavernous sinus fistula was first described around 1970s. We report a case of coil embolization of carotid cavernous sinus fistula using a superior ophthalmic vein approach. METHODS: A 70-year-old female had a 3-month history of headache, periocular pain, and diplopia. Diagnostic orbital contrast-enhanced CT, brain MRI and contrast-angiography and cerebral angiography revealed a carotid cavernous sinus fistula. Fistula occlusion via transfemoral endovascular embolization failed, so we then tried coil embolization using an external superior ophthalmic vein approach of carotid cavernous sinus fistula. RESULTS: The coil embolization via an external superior ophthalmic vein approach was difficult because of venous tortuosity and poor exposure of part of orbital roof area. But, X-ray-guided direct puncture of the superior ophthalmic vein was successful. We thus had good results with coil embolization of carotid cavernous fistula. CONCLUSIONS: The coil embolization via superior ophthalmic vein approach is an effective and challengeable treatment when surgical cauterization or conventional endovascular embolization fails. We suggest that there is need to training ophthalmologists to be experienced in external orbital surgery.
