Cavernous sinus dural arteriovenous fistula treated by facial vein direct puncture: Case report and review of the literature. Issue 3 (June 2017)

• Record Type: Journal Article
• Authors: Matsumoto, Atsushi; Okauchi, Masanobu; Shindo, Atsushi; Kawanishi, Masahiko; Tamiya, Takashi
• Is Part Of: Interventional neuroradiology. Volume 23:Issue 3(2017:Jun.)
• Page Start: 301
• Page End: 306
• Publication Date: 2017-06
• Subjects: Cavernous sinus dural arteriovenous fistula -- facial vein approach -- percutaneous direct puncture -- transvenous embolization; Nervous system -- Interventional radiology -- Periodicals; Nervous system -- Radiography -- Periodicals; Nervous System Diseases -- Periodicals -- radiography; Neuroradiography -- Periodicals; Radiography, Interventional -- Periodicals; Nervous system -- Radiography; Periodicals; 617.4805
• DOI: 10.1177/1591019917693413
• Languages: English
• ISSNs: 1591-0199

Abstract

Introduction: In case of cavernous sinus dural arteriovenous fistula (CSDAVF), transvenous embolization (TVE) of the cavernous sinus (CS) via the inferior petrosal sinus (IPS) is generally performed. However, various approach routes have been reported when the accessibility of the IPS is challenging. We herein report a case of CSDAVF treated by TVE with direct puncture of the facial vein. Case report: A 70-year-old woman who suffered from tinnitus, chemosis, diplopia and bruit was referred to our hospital. Digital subtraction angiography (DSA) demonstrated CSDAVF. We initially attempted to perform TVE via the IPS route; however, we could not guide a catheter to the CS because of an anatomical difficulty. Then, we performed percutaneous direct puncture of the dilated facial vein, and successfully treated the patient. Conclusion: When navigating microcatheter to the CS is difficult because of an anatomical difficulty of the IPS, direct puncture of the facial vein is a feasible route.