title: Inferior petrosal sinus route microcatheterization study and embolization for primary orbital varix.
abstract: OBJECTIVE
  Primary orbital varix is a rare lesion but difficult to treat. Our main aim was to demonstrate the varices and their central venous communication and to explore the feasibility of embolization of these lesions.
  
  
  METHODS
  In four patients with clinical suspicion of varix, in whom MRI showed retro-global vascular channels, microcatheter digital subtraction angiography (DSA) of the varices was performed using femoral venous access. Embolization was carried out in two patients.
  
  
  RESULTS
  In all four patients orbital varices could be accessed with a microcatheter through inferior petrosal sinus and ophthalmic vein (superior or inferior) route. Microcatheter angiography showed opacification of varices and demonstrated their central venous communication. Two patients were treated with coil embolization. Complete resolution of symptoms was seen in one patient and partial relief in the other.
  
  
  CONCLUSIONS
  The study presents microcatheterization of orbital varices via the inferior petrosal sinus-cavernous sinus-ophthalmic vein route with injections into distal ophthalmic veins for demonstration of these variceal sacs and their central venous connection. Coiling to disconnect the venous communication should be the primary goal of embolization.
authors.affiliation: Department of Radiodiagnosis, SGPGIMS, Lucknow, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Singh
authors.affiliation: Department of Radiodiagnosis, SGPGIMS, Lucknow, India rphadke849@gmail.com.
authors.forename: R V
authors.initials: RV
authors.lastname: Phadke
authors.affiliation: Department of Radiodiagnosis, SGPGIMS, Lucknow, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Udiya
authors.affiliation: Department of Radiodiagnosis, SGPGIMS, Lucknow, India.
authors.forename: Gurucharan S
authors.initials: GS
authors.lastname: Shetty
authors.affiliation: Department of Neuro-Ophthalmology, SGPGIMS, Lucknow, India.
authors.forename: Kumudini
authors.initials: K
authors.lastname: Sharma
authors.affiliation: Department of Neuro-Ophthalmology, SGPGIMS, Lucknow, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Kanaujia
mesh_terms: D000328:Adult; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000628:therapy*; D057785:Catheters; D003131:Combined Modality Therapy / Q000379:methods; D003392:Cranial Sinuses / Q000000981:diagnostic imaging; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008904:Miniaturization; D009915:Orbit / Q000098:blood supply* / Q000000981:diagnostic imaging; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult
keywords: Orbital varix; embolization; neuro-ophthalmology