title: Efficacy of a unique straight, conformable, bare platinum coil in the treatment of cavernous sinus dural arteriovenous fistula.
abstract: In embolization of a cavernous sinus (CS) by transvenous embolization (TVE) for a CS dural arteriovenous fistula (DAVF), selection of embolization coils is difficult owing to the complex anatomical structure of the CS. Moreover, overpacking of the CS with embolization coils may cause permanent cranial nerve palsies. The ED coil-10 (EDC-10) infini is an extremely soft platinum coil without shape-memory that has excellent conformability with surrounding structures. The goal of this study was to evaluate use of the EDC-10 infini coil for embolization of a CS DAVF. Six patients with a CS DAVF were treated with TVE. Refluxing cerebral and ophthalmic veins were embolized with shape-memory type coils other than EDC-10 infini, and CSs were embolized with the EDC-10 infini coils. In five cases, CSs were loosely embolized with EDC-10 infini coils. In one case, reflux of the cerebral vein worsened from the CS during the procedure, and embolization of the CS tightly using three-dimensional shape-memory type coils other than EDC-10 infini. Overall, three to 19 (average 7.3) coils were used fozr each CS and the total coil volume was 33-284 (average 95.1) mm(3) in each CS. Postoperative transient abducens palsy occurred in two cases, but both patients recovered completely. There was no case of recurrence. The EDC-10 infini coil showed excellent conformability with the complex inner structure of the CS and excellent safety without postoperative permanent cranial nerve palsy.
authors.affiliation: Department of Neuro-Vascular Surgery, Heart & Neuro-Vascular Center, Fukuoka Wajiro Hospital, Japan keihara@f-wajirohp.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Neuro-Vascular Surgery, Heart & Neuro-Vascular Center, Fukuoka Wajiro Hospital, Japan.
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kakumoto
mesh_terms: D000368:Aged; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D002426:Cavernous Sinus; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010984:Platinum; D016896:Treatment Outcome
chemical_list: D010984:Platinum
keywords: Dural arteriovenous fistula; cavernous sinus; platinum coil; transvenous embolization