A case of carotid cavernous sinus fistula treated with a direct puncture to the thrombosed superior ophthalmic vein

DOI Web Site Web Site 2 Citations 8 References
  • WAKUI Daisuke
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • TERADA Tomoaki
    Department of Neurosurgery, Wakayama Laborers' Hospital
  • OSHIMA Kosuke
    Department of Neurosurgery, Ishioka Cardiology and Neurosurgery Hospital
  • NAKAMURA Homare
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • SAKAKIBARA Yohtaro
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • MATSUMORI Takashi
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • KOBAYASHI Atsushi
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital
  • ITO Hidemichi
    Department of Neurosurgery, St. Marianna University School of Medicine
  • MORISHIMA Hiroyuki
    Department of Neurosurgery, Kawasaki City Tama Hospital
  • TAGUCHI Yoshio
    Department of Neurosurgery, St. Marianna University School of Medicine, Yokohama City Seibu Hospital

Bibliographic Information

Other Title
  • 血栓化した上眼静脈へのdirect punctureにより根治的治療を行ったCCFの1例
  • ケッセンカ シタ ジョウガン ジョウミャク エ ノ direct puncture ニ ヨリ コンジテキ チリョウ オ オコナッタ CCF ノ 1レイ

Search this article

Description

Objective: We report a unique case of carotid cavernous fistula (CCF) with thrombosed draining vein, making usual transvenous approaches impossible.<br>Case presentation: This 69-year-old male patient presented with typical symptoms of CCF. Cerebral angiography revealed left CCF being fed by bilateral meningohypophyseal trunks (MHTs). Presumably due to anatomical variations of the cavernous sinus, attempts to access the shunting point by using the usual inferior petrosal sinus route failed. Thereafter peripheral draining vein thromboses might cause paradoxical worsening. Since urgent treatment appeared necessary, a transvenous coil embolization via direct puncture of the superior ophthalmic vein (SOV) was performed to obliterate the shunting point. Postoperatively that patient's visual symptoms recovered well.<br>Conclusion: Direct puncture of the SOV to obliterate CCF is a possible alternative choice of treatment when the usual transvenous access route was available. To reduce risk of complications we believe biplane angiographical devices, preparation of liquid embolic material, 20G elastic needles, and prevention of heparinization are necessary.

Journal

Citations (2)*help

See more

References(8)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top