Ophthalmologic outcome of transvenous embolization of spontaneous carotid-cavernous fistulas: a preliminary report

We give a preliminary report of the ophthalmologic outcome of four patients with transvenous embolization studied for their spontaneous carotid-cavern ous fistulas. One of them is a direct type while three of them are indirect dural shunts. In indirect dural shunts, traditional transarterial emboliza tion rarely achieves a complete clinical cure in a short period of time. Al l cases had an ophthalmologic disturbance justified for endovascular interv ention. We performed catheterization, and subsequently embolization with Gu glielmi Detachable coils, to the cavernous sinus via the femoral vein and i nferior petrosal sinus/superior ophthalmic vein. All four patients achieved clinical and angiographic improvement with a follow-up period range from t wo to sixteen months except for one patient who had residual bilateral sixt h nerve palsy. The transvenous approach offers an effective and safe altern ative for the management of spontaneous carotid-cavernous fistula.