Radiographic and clinical outcomes in cavernous carotid fistula with special focus on alternative transvenous access techniques

Morton, Ryan P.; Tariq, Farzana; Levitt, Michael R.; Nerva, John D.; Mossa‐Basha, Mahmud; Sekhar, Laligam N.; Kim, Louis J.; Hallam, Danial K.; Ghodke, Basavaraj

doi:10.1016/j.jocn.2014.11.006

Cited by 21 publications

(13 citation statements)

References 27 publications

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“…These can be transvenous access routes to the CS via facial veins or by direct puncture of the SOV. 37 – 39) Spector et al 40) described a detailed venous anatomy at the junction of the orbit and the CS, and the close continuation of the lateral wall of the SOV stem to the inner layer of the CS lateral wall. It suggests the topographic relations of the SOV to the anterior CS that is situated between cranial nerves and the ICA.…”

Section: Venous Drainage Into the Cs From Different Structuresmentioning

confidence: 99%

Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations

Mitsuhashi

Hayasaki

Kawakami

et al. 2016

Neurol. Med. Chir.(Tokyo)

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The cavernous sinus (CS) is one of the cranial dural venous sinuses. It differs from other dural sinuses due to its many afferent and efferent venous connections with adjacent structures. It is important to know well about its complex venous anatomy to conduct safe and effective endovascular interventions for the CS. Thus, we reviewed previous literatures concerning the morphological and functional venous anatomy and the embryology of the CS. The CS is a complex of venous channels from embryologically different origins. These venous channels have more or less retained their distinct original roles of venous drainage, even after alterations through the embryological developmental process, and can be categorized into three longitudinal venous axes based on their topological and functional features. Venous channels medial to the internal carotid artery “medial venous axis” carry venous drainage from the skull base, chondrocranium and the hypophysis, with no direct participation in cerebral drainage. Venous channels lateral to the cranial nerves “lateral venous axis” are exclusively for cerebral venous drainage. Venous channels between the internal carotid artery and cranial nerves “intermediate venous axis” contribute to all the venous drainage from adjacent structures, directly from the orbit and membranous skull, indirectly through medial and lateral venous axes from the chondrocranium, the hypophysis, and the brain. This concept of longitudinal venous axes in the CS may be useful during endovascular interventions for the CS considering our better understandings of its functions in venous drainage.

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Section: Venous Drainage Into the Cs From Different Structuresmentioning

confidence: 99%

Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations

Mitsuhashi

Hayasaki

Kawakami

et al. 2016

Neurol. Med. Chir.(Tokyo)

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“…If this route is not available, the CS can usually be accessed via alternative venous routes such as the SOV, facial vein, pterygoid plexus and via direct percutaneous puncture. 2 Occasionally, even these alternative venous routes may not be available, rendering access to the CS and treatment of the CCF particularly challenging. Hence, there is an interest in having potential alternative access routes available for these challenging cases.…”

Section: Discussionmentioning

confidence: 99%

“…1 If this route is not available, either due to anatomic variation or thrombosis, the CS can usually be accessed via alternative venous routes such as the superior ophthalmic vein (SOV), facial vein, and via direct percutaneous puncture. 2 Occasionally, even these alternative venous routes may not be available, rendering access to the CS particularly challenging.…”

Section: Introductionmentioning

confidence: 99%

Embolization of a cavernous carotid fistula through the vein of Labbé: a new alternative transvenous access route

Konstas

Song

et al. 2017

BMJ Case Reports

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Endovascular treatment of carotid cavernous fistulas (CCFs) via a transvenous approach is standard, but in rare cases this approach is challenging due to absence or thrombosis of the commonly used venous routes. A 61-year-old woman presented with a symptomatic CCF with all but one of the venous access routes to the CCF thrombosed, leaving an engorged superficial middle cerebral vein (SMCV) as the only venous outflow from the cavernous sinus. Access to the CCF was made possible after careful navigation of the sigmoid sinus, the vein of Labbé and the SMCV, bypassing the need for surgical access to the SMCV or for a direct transorbital puncture. The CCF was completely occluded by coiling and Onyx embolization. The patient made an uneventful recovery, with resolution of her symptoms. To the best of our knowledge, this access route has not been previously reported in the treatment of CCFs.

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“…We have previously published our experience with CCF including alternative transvenous access techniques 8. Although a transvenous approach to cavernous sinus embolization may be less effective than transarterial embolization in the treatment of direct CCF, there is substantial risk associated with arterial access in patients with vEDS using this approach with reported mortality rates of up to 58% 3.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique

et al. 2017

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We report successful transvenous treatment of direct carotid-cavernous fistula in a patient with Ehlers-Danlos syndrome type IV using a novel triple-overlay embolization (TAILOREd) technique without the need for arterial puncture, which is known to be highly risky in this patient group. The TAILOREd technique allowed for successful treatment using preoperative MR angiography as a three-dimensional overlay roadmap combined with cone beam CT and live fluoroscopy, precluding the need for an arterial puncture.

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Radiographic and clinical outcomes in cavernous carotid fistula with special focus on alternative transvenous access techniques

Cited by 21 publications

References 27 publications

Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations

Dural Venous System in the Cavernous Sinus: A Literature Review and Embryological, Functional, and Endovascular Clinical Considerations

Embolization of a cavernous carotid fistula through the vein of Labbé: a new alternative transvenous access route

Successful treatment of direct carotid–cavernous fistula in a patient with Ehlers–Danlos syndrome type IV without arterial puncture: the transvenous triple-overlay embolization (TAILOREd) technique

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