Transarterial embolisation of complex cavernous sinus dural arteriovenous fistulae with low-concentration cyanoacrylate.
We report the effectiveness of low-concentration n-butyl-2-cyanoacrylate (NBCA)-Lipiodol-tungsten mixture (10-15 %) in the management of patients with aggressive or recurrent complex cavernous dural arteriovenous fistulae (CSDAVF). We treated five patients with complex CSDAVF with a low concentration of an NBCA-Lipiodol-tungsten mixture after catheterisation of the feeding arteries arising from the external carotid artery. Three had a recurrent CSDAVF after transarterial particulate embolisation. Three refused transvenous treatment or could not be treated in this way; two patients had also feeding dural branches of the internal carotid artery. All patients had complete resolution of symptoms and signs within a month of the procedure. No definite neurological complication was found during follow-up ranging from 12 to 36 months. Transarterial embolisation with low-concentration cyanoacrylate appears to be an effective alternative management of aggressive or recurrent CSDAVF.
Liu
H M
HM
Department of Radiology, Medical College, National Taiwan University Hospital, Taipei, ROC. hml@ha.mc.ntu.edu.tw
Huang
Y C
YC
Wang
Y H
YH
Tu
Y K
YK
D001164:Arteriovenous Fistula / Q000628:therapy*; D002426:Cavernous Sinus; D004388:Dura Mater / Q000098:blood supply*; D004621:Embolization, Therapeutic; D004659:Enbucrilate / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D007459:Iodized Oil; D008297:Male; D008875:Middle Aged
D007459:Iodized Oil; D004659:Enbucrilate