Direct approach to thrombosed superior ophthalmic vein of recalcitrant indirect carotid cavernous fistula in thrombocythemia failed with multiple conventional embolization treatment

Superior ophthalmic approach in carotid-cavernous fistula: current concepts in indications, surgical techniques, and case reviews

“…However, once the thrombosed portion is passed, the catheter is filled with pulsating blood. 21) The majority of SOV attempts are successful; however, they may fail due to thrombosis of the SOV. According to previous studies, segmental thrombosis of the SOV hinders successful cannulation through the SOV.…”

“…16) Embolization of the CCF via the SOV has been regarded as a successful alternative to the IPS or even the transarterial approach. 15) [19][20][21] Fragile, undersized, thrombosed, or related vascular abnormalities may occasionally impede cannulation of the SOV; however, the effectiveness of the SOV approach has been described even in the presence of SOV thrombosis and in a variety of conditions. 15)20)21) 27) In this review, the author discusses the embolization of CS-dAVF as well as the direct CCF through the SOV method, along with their respective experiences.…”

Surgical Tips for Approaching to Superior Ophthalmic Vein in Patients with a Carotid Cavernous Fistula

“…However, both patients have their conventional pathway of embolization, the ipsilateral and the contralateral IPS were obstructed. Therefore, the authors attempted an ipsilateral SOV approach as described above and basically based on the method as we reported, previously (2). Some variations in the anatomy and the dimensions of the orbital veins make circumstances difficult (3,4).…”

“…However, both patients have their conventional pathway of embolization, the ipsilateral and the contralateral inferior petrosal sinus were obstructed. Therefore, the authors attempted an ipsilateral SOV approach as described above and basically based on the method as we reported, previously [ 2 ].…”