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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Results of Transvenous Embolization of Cavernous Dural Arteriovenous Fistula: A Single-Center Experience with Emphasis on Complications and Management

D.J. Kim, D.I. Kim, S.H. Suh, J. Kim, S.K. Lee, E.Y. Kim and T.S. Chung
American Journal of Neuroradiology November 2006, 27 (10) 2078-2082;
D.J. Kim
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D.I. Kim
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S.H. Suh
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J. Kim
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S.K. Lee
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E.Y. Kim
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T.S. Chung
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    Fig 1.

    A 60-year-old man presented with symptoms of decreased visual acuity, exophthalmos, and chemosis of the left eye of 1 month’s duration.

    A, Initial left ICA angiogram revealed an arteriovenous shunt at the left cavernous sinus with drainage into the superior ophthalmic and inferior ophthalmic veins.

    B, Transvenous coil embolization of the left cavernous sinus was performed via a left SOV approach, resulting in nearly complete occlusion of the target sinus with slow but stagnant flow in the anterior pontomesencephalic veins (arrows).

    C, Fluid-attenuated inversion recovery images of the patient after he developed mild dysarthria shows congestion of the brain stem. Bilateral graft stents were deployed for occlusion of the residual meningohypophyseal feeders.

    D, Poststent left ICA angiogram shows complete occlusion of the residual shunt.

Tables

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    Table 1:

    Characteristics of patients and results of transvenous embolizations

    CharacteristicsIncidence (%)
    Age (years)30–73; mean, 57
    Sex
        Male11 (20)
        Female45 (80)
    Initial presenting symptoms
        Chemosis18 (32)
        Exophthalmos12 (21)
        Orbital pain19 (34)
        Loss of visual acuity7 (13)
        Diplopia19 (34)
        Ptosis7 (13)
        Headache12 (21)
    Venous approach routes
        Inferior petrosal sinus36 (64)
        Intercavernous sinus4 (7)
        Facial vein7 (13)
        Direct ophthalmic vein3 (5)
    Angiographic results
        Complete29 (52)
        Nearly complete13 (23)
        Incomplete14 (25)
    Clinical outcome (n = 46)
        Improvement42 (91)
        No improvement2 (4)
        Recurred2 (4)
    • View popup
    Table 2:

    Characteristics of cranial nerve palsy caused by transvenous embolizations of the cavernous sinus

    Sex/AgeCranial NerveIPS OcclusionRouteMaterialsDSA OutcomeManagement of ComplicationsOutcome
    F/46VNoIpsi CSPlat (1)IncompleteSymptomaticImproved
    Tungst (3)
    M/65VINoIpsi CSTungst (4)IncompleteSymptomaticImproved
    F/58VIYesIpsi CSTorn (5)CompleteSymptomaticMild residue
    Plat (22)
    Tungst (12)
    F/69VINoInterCSTungst (9)IncompleteSymptomaticImproved
    Plat (10)
    F/30VINoIpsi CS+ TAEDCS (1)CompleteSymptomaticImproved
    Torn (18)
    M/52VINoIpsi CSTrufill (13)CompleteSymptomaticImproved
    Torn (2)
    • Note:—IPS indicates inferior petrosal sinus; Ipsi, ipsilateral; CS, cavernous sinus; InterCS, intercavernous sinus; Plat, platinum coil; Tungst, tungsten coil; Torn, tornado coil; DCS, detachable coil system; TAE, transarterial embolization; DSA, digital subtraction angiography.

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American Journal of Neuroradiology: 27 (10)
American Journal of Neuroradiology
Vol. 27, Issue 10
November 2006
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Results of Transvenous Embolization of Cavernous Dural Arteriovenous Fistula: A Single-Center Experience with Emphasis on Complications and Management
D.J. Kim, D.I. Kim, S.H. Suh, J. Kim, S.K. Lee, E.Y. Kim, T.S. Chung
American Journal of Neuroradiology Nov 2006, 27 (10) 2078-2082;
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Cite this article
D.J. Kim, D.I. Kim, S.H. Suh, J. Kim, S.K. Lee, E.Y. Kim, T.S. Chung
Results of Transvenous Embolization of Cavernous Dural Arteriovenous Fistula: A Single-Center Experience with Emphasis on Complications and Management
American Journal of Neuroradiology Nov 2006, 27 (10) 2078-2082;

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