Acta Neurochirurgica

, 150:557 | Cite as

Embolisation of indirect carotid-cavernous sinus dural arterio-venous fistulae using the direct superior ophthalmic vein approach

  • J.-W. Lee
  • D.-J. Kim
  • J.-Y. Jung
  • S.-H. Kim
  • S.-K. Huh
  • S.-H. Suh
  • D.-I. Kim
Clinical Article


Indirect carotid-cavernous sinus dural arterio-venous fistulae (cDAVF) can be treated by transarterial and/or transvenous embolisation. This study evaluated patients with cDAVF who underwent transvenous embolisation using the direct superior ophthalmic vein (SOV) approach. Between January 2004 and October 2006, eight cDAVF in seven patients were embolised using direct surgical exposure of the SOV when access to the cDAVF via transarterial or transfemoral venous routes was not feasible. Medical records and imaging studies were retrospectively reviewed. The seven patients consisted of four females and three males from 43 to 65-year-old (mean age, 54.4 years). Six cDAVF lesions were located on the left side and two on the right. All fistulae were successfully embolised and showed clinical improvement. One patient presented after treatment with transient venous congestion on the brain stem, which was relieved by osmotic diuretics and steroids. Direct surgical exposure of the SOV for transvenous embolisation of cDAVF can be effective if the facial vein, inferior petrosal sinus, and internal jugular vein are thrombosed. This approach is easy, safe, and effective when performed by a multidisciplinary team.

Keywords: Indirect; carotid-cavernous sinus; dural arteriovenous fistula; embolisation; direct superior ophthalmic vein approach. 


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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • J.-W. Lee
    • 1
  • D.-J. Kim
    • 2
  • J.-Y. Jung
    • 1
  • S.-H. Kim
    • 1
  • S.-K. Huh
    • 1
  • S.-H. Suh
    • 2
  • D.-I. Kim
    • 2
  1. 1.Department of Neurosurgery, Brain Research InstituteYonsei University College of MedicineSeoulKorea
  2. 2.Department of Radiology, Brain Research InstituteYonsei University College of MedicineSeoulKorea

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