Transvenous embolization of bilateral indirect carotid-cavernous fistulas via a unilateral transorbital approach. Orbit 2021 Aug;40(4):320-325
Date
06/20/2020Pubmed ID
32552143DOI
10.1080/01676830.2020.1779753Scopus ID
2-s2.0-85087184698 (requires institutional sign-in at Scopus site)Abstract
A 73-year-old man with a complex ophthalmologic history presented with several weeks of worsening diplopia, visual acuity, and proptosis bilaterally. Cerebral angiography demonstrated bilateral indirect Barrow type B carotid-cavernous fistulas (CCFs). Transarterial embolization was not attempted due to small arterial diameter and risk of stroke. Multiple attempts were made to access the fistula via a transfemoral venous approach and were unsuccessful. A transorbital puncture was performed, which allowed access to both cavernous sinuses via a unilateral approach. After embolization with Onyx, there was no residual fistula. The patient had a left-sided retrobulbar hematoma from the access. Right eye vision improved postoperatively.
Author List
Laplant JF, Lim LH, Dumont AS, Nerva JDAuthors
Jacquelyn Laplant MD Assistant Professor in the Ophthalmology and Visual Sciences department at Medical College of WisconsinJohn D. Nerva MD Assistant Professor in the Neurosurgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AgedCarotid-Cavernous Sinus Fistula
Cavernous Sinus
Cerebral Angiography
Embolization, Therapeutic
Fistula
Humans
Male
