Transvenous embolisation for cavernous dural arteriovenous shunts: case selection and methods of embolisation
To evaluate the efficacy of transvenous embolisation for cavernous dural arteriovenous shunts (CdAVS) as a primary treatment modality, angiographic classification based on the drainage system and embolisation methods were analysed. From May 1987 to March 1994, of 76 cases admitted we treated 53 cases (7 men, 46 women aged 38–85 years, average 64.3 years; bilateral lesions in 9) of CdAVS by transvenous embolisation. Based on the venous drainage pattern and shunting architecture, the appropriate approach and method of embolisation were selected. Sixty transvenous embolisation procedures (via the superior ophthalmic vein in 22, the inferior betrosal sinus in 36, both in 2) were performed. Immediately after embolisation, we achieved complete radioanatomical cure in 33 cases (62.3%). Complete cure rate at follow-up (average follow-up 8.9 months) was 94.3%. Complications included transient cavernous sinus syndrome in 8, redirection of venous flow in 2, posterior ischaemic optic neuropathy in 1, and cerebral infarction in 1. Transvenous embolisation for CdAVS would offer satisfactory therapeutic efficacy when applied considering venous drainage pattern and shunting architecture.
Key wordsDura mater Arteriovenous shunts Embolisation Vein Coils
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