Superior ophthalmic vein puncture: an alternative approach to treat complex cavernous sinus fistulae

The Superior Ophthalmic Vein Approach for the Treatment of Carotid-Cavernous Fistulas: Our First Experience

“…Complications of SOV exposure include bleeding and difficulty in identifying the vein. Some authors have also reported injury of the levator muscle and supraorbital nerve, infection, granuloma, and damage to the troclea [7,12]. Intracranial dural arteriovenous fistulae are acquired arteriovenous shunts located inside the duramater.…”

The superior ophthalmic vein approach for the treatment of carotid-cavernous fistulas: our first experience

“…Once the loss of vision is complete, even with treatment, optic nerve function is difficult to recover. In case of cortical vein drainage implication the risk of intra-parenchymal hemorrhage must be taken in to consideration [3,8].…”

“…Conventional angiography remains the most accurate method for detection and classification of carotid cavernous fistulae by precise location and delimitation of fistula site and superior visualization of arterial feeders and venous outflow [1,3,4,8].…”

“…With the introduction of transvenous embolization trough the femoral vein and inferior petrosal sinus by Uflacker et al in 1986 these technique become the treatment of choice for such lesions [1,3,6,8]. So, transvenous embolizations by occlusion of the cavernous sinus with coils become treatment of choice for Barrow type B-D indirect CCFs.…”

“…Carotidcavernous fistulas (CCF) are abnormal vascular communications between the cavernous sinus and the carotid artery and/or its branches. These vascular lesions are broadly grouped into two: direct and indirect types [1,3,8]. The direct CCF are direct shunt between the cavernous sinus and the internal carotid artery whereas the indirect CCF are dural fistulas between the cavernous sinus and extradural branches of the internal carotid artery, the external carotid artery, or both.…”