Transvenous embolization of cavernous sinus dural arteriovenous fistulas using detachable coils and Glubran 2 acrylic glue via the inferior petrosal sinus approach.
OBJECTIVE
To describe the technique, efficacy, and safety of transvenous embolisation (TVE) of cavernous sinus arteriovenous fistulas (CSDAVFs) via the inferior petrosal sinus (IPS) with detachable coils and acrylic glue.


METHODS
Spontaneous unilateral CSDAVFs were confirmed by cerebral angiography in eight patients, with angiographic patency of the ipsilateral IPS in three and angiographic non-visualisation of the ipsilateral IPS in five. There were two patients with complete occlusion of the ipsilateral internal jugular vein (IJV). TVE with detachable coils and acrylic glue were performed through a femoral vein and an IPS approach.


RESULTS
TVE viaipsilateral IPS was successfully performed in all eight patients in our group. The number of detachable coils for each patient ranged from 2 to 8 (mean, 5.0). Angiography immediately after TVE showed complete occlusion of the CSCAVFs in seven patients and nearly complete occlusion in one. Complete recovery of clinical symptoms was achieved in all eight patients. No recurrence of clinical symptoms was observed at follow-up.


CONCLUSIONS
Transvenous embolisation via an IPS approach is a highly efficient and safe treatment for CSDAVFs. Embolisation with a combination of coils and acrylic glue may help to achieve complete occlusion of fistulas with fewer coils.
Li
Zheng-Ran
ZR
Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Tianhe Road 600, Guangzhou, People's Republic of China, 510630.
Jiang
Zai-Bo
ZB
Huang
Ming-Sheng
MS
Zhu
Kang-Shun
KS
Wang
Qing
Q
Shan
Hong
H
D000328:Adult; D000368:Aged; D002339:Carotid Arteries / Q000002:abnormalities*; D002426:Cavernous Sinus / Q000002:abnormalities*; D020785:Central Nervous System Vascular Malformations / Q000628:therapy*; D003487:Cyanoacrylates / Q000627:therapeutic use*; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D003487:Cyanoacrylates; D006490:Hemostatics; C421461:glubran 2