Transarterial embolization with coils via accessory meningeal artery for the cavernous sinus dural arteriovenous fistula: a case report

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  • 副硬膜動脈経由による海綿静脈洞部硬膜動静脈瘻に対する経動脈的コイル塞栓術の1 例
  • 症例報告 副硬膜動脈経由による海綿静脈洞部硬膜動静脈瘻に対する経動脈的コイル塞栓術の1例
  • ショウレイ ホウコク フクコウマク ドウミャク ケイユ ニ ヨル カイメン ジョウミャクドウブコウマクドウ ジョウミャクロウ ニ タイスル ケイ ドウミャクテキ コイル ソクセンジュツ ノ 1レイ

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Objective: We hereby report a rare case of Barrow type B cavernous sinus dural arteriovenous fistula (CSdAVF) thatwas treated by coiling the affected sinus through a trans-arterially placed microcatheter via the ipsilateral accessorymeningeal artery (AMA).<br>Case presentation: A 75-year-old man presented with chemosis and exophthalmos on his left eye. The patient didnot have a previous medical history of head trauma. Left external carotid artery angiogram revealed a CSdAVF withtwo feeders, the accessory meningeal artery and artery of foramen rotundum. Retrograde venous drainage was seen tothe ipsilateral superior orbital and deep middle cerebral veins. During the intervention, a microcatheter was advancedbeyond the fistula into the cavernous sinus through the large AMA. The microcatheter was easily manipulated in thesinus and packing of the sinus was achieved with coils.<br>Conclusion: A rare case of CSdAVF treated by trans-arterial coiling via the AMA is reported. The trans-arterialapproach to the cavernous sinus may be an unexpected option and should be considered in case with limited access tothe sinus.

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