Cavernous sinus fistula treated through the transvenous approach: report of four cases.
OBJECTIVE
To describe transvenous embolization in four patients with indirect dural carotid cavernous fistulas (CCFs) via the inferior petrosal sinus (IPS) or superior ophthalmic vein (SOV), and their clinical outcomes.


METHODS
The CCF approach was performed after retrograde venous catheterization from the femoral vein to the cavernous sinus via the IPS (n=1) or SOV (n=3). SOV catheterization was possible without surgical intervention. All patients presented initially with typical clinical signs of CCF. Patients treated via the SOV presented with thrombosis of the IPS.


RESULTS
Catheterization and embolization were successful in all patients, with complete angiographic occlusion of the fistula. No early or late complications occurred. All patients presented with favorable clinical outcomes and complete recovery of ocular symptoms.


CONCLUSIONS
Retrograde transvenous embolization of CCF via the IPS, or SOV if the IPS is thrombosed, is a safe procedure with a good clinical outcome.
Bing
F
F
Service de neuroradiologie, CHU de Grenoble, 38043 Grenoble cedex 09, France. fbing@chu-grenoble.fr
Albrieux
M
M
Vinh Moreau-Gaudry
V
V
Vasdev
A
A
D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D020216:Carotid-Cavernous Sinus Fistula / Q000150:complications / Q000473:pathology / Q000628:therapy*; D002404:Catheterization / Q000379:methods*; D002426:Cavernous Sinus / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005268:Femoral Vein; D007839:Functional Laterality; D006801:Humans; D008875:Middle Aged; D015840:Oculomotor Nerve Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy; D013927:Thrombosis / Q000473:pathology / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014786:Vision Disorders / Q000209:etiology / Q000473:pathology / Q000628:therapy