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Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula.

Zenteno M, Jorge SF, Rafael MS, Raphael AH, Gabriel AC, Ángel L - Asian J Neurosurg (2015 Jan-Mar)

Bottom Line: carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis.A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity.The endovascular management of these lesions is currently possible with excellent results.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroradiology and Endovascular Therapy, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, México, Mexico.

ABSTRACT
carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis. They are clinically characterized by ophthalmological symptoms and pulsatile tinnitus. A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity. Caotid-cavernous fistula wes diagnosed, for the technical difficulty inherent in the case was made a contralateral transvenous approach and embolization with 360° GDG coils, with successful evolution of the patient. The endovascular management of these lesions is currently possible with excellent results.

No MeSH data available.


Related in: MedlinePlus

Digital subtraction (a: Lateral view, b: Left oblique view, and c: Later view and more lateralized than b) and selective three-dimensional (d: AP view) angiography of the left internal carotid artery. It is seen the pass to the left cavernous sinus through meningeal branches of the meningohipofisarial and inferolateral trunks (b and d, thin arrows). The contrast material passes through intercavernous sinus (b and d, arrows) into the right cavernous sinus (a, b and d, arrowheads). Retrograde flow is observed from the inferiro petrosal sinus (a, b, c and d, thick arrow) and the ophthalmic vein (c, star)
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Figure 3: Digital subtraction (a: Lateral view, b: Left oblique view, and c: Later view and more lateralized than b) and selective three-dimensional (d: AP view) angiography of the left internal carotid artery. It is seen the pass to the left cavernous sinus through meningeal branches of the meningohipofisarial and inferolateral trunks (b and d, thin arrows). The contrast material passes through intercavernous sinus (b and d, arrows) into the right cavernous sinus (a, b and d, arrowheads). Retrograde flow is observed from the inferiro petrosal sinus (a, b, c and d, thick arrow) and the ophthalmic vein (c, star)

Mentions: Cerebral panangiography was performed with digital subtraction using Seldinger technique in three-dimensional biplane angiography axiom artis (Siemens, Germany). Through selective catheterization of the ICA and the external carotid artery (ECA) was evidenced the presence of a dural fistula to the left cavernous sinus through dural branches of ICA cavernous segment [Figure 3] and the internal maxillary artery [Figure 4], with retrograde flow into contralateral cavernous sinus through intercavernous sinus, and thence to the superior ophthalmic vein, right pteriogoid plexus and inferior petrosal right sinus.


Contralateral transvenous approach and embolization with 360° guglielmi detachable coils for the treatment of cavernous sinus dural fistula.

Zenteno M, Jorge SF, Rafael MS, Raphael AH, Gabriel AC, Ángel L - Asian J Neurosurg (2015 Jan-Mar)

Digital subtraction (a: Lateral view, b: Left oblique view, and c: Later view and more lateralized than b) and selective three-dimensional (d: AP view) angiography of the left internal carotid artery. It is seen the pass to the left cavernous sinus through meningeal branches of the meningohipofisarial and inferolateral trunks (b and d, thin arrows). The contrast material passes through intercavernous sinus (b and d, arrows) into the right cavernous sinus (a, b and d, arrowheads). Retrograde flow is observed from the inferiro petrosal sinus (a, b, c and d, thick arrow) and the ophthalmic vein (c, star)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4352642&req=5

Figure 3: Digital subtraction (a: Lateral view, b: Left oblique view, and c: Later view and more lateralized than b) and selective three-dimensional (d: AP view) angiography of the left internal carotid artery. It is seen the pass to the left cavernous sinus through meningeal branches of the meningohipofisarial and inferolateral trunks (b and d, thin arrows). The contrast material passes through intercavernous sinus (b and d, arrows) into the right cavernous sinus (a, b and d, arrowheads). Retrograde flow is observed from the inferiro petrosal sinus (a, b, c and d, thick arrow) and the ophthalmic vein (c, star)
Mentions: Cerebral panangiography was performed with digital subtraction using Seldinger technique in three-dimensional biplane angiography axiom artis (Siemens, Germany). Through selective catheterization of the ICA and the external carotid artery (ECA) was evidenced the presence of a dural fistula to the left cavernous sinus through dural branches of ICA cavernous segment [Figure 3] and the internal maxillary artery [Figure 4], with retrograde flow into contralateral cavernous sinus through intercavernous sinus, and thence to the superior ophthalmic vein, right pteriogoid plexus and inferior petrosal right sinus.

Bottom Line: carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis.A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity.The endovascular management of these lesions is currently possible with excellent results.

View Article: PubMed Central - PubMed

Affiliation: Department of Neuroradiology and Endovascular Therapy, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Tlalpan, México, Mexico.

ABSTRACT
carotid-cavernous fistulas are spontaneours acquired connections between the carotid artery and the cavernous cavernous sinus, being classified as direct or indirect; being usually diagnosed in postmenopausal women, but are also associated with other pathoogies such as pregnancy, sinusitis and cavernous sinus thrombosis. They are clinically characterized by ophthalmological symptoms and pulsatile tinnitus. A 51-year-old woman who started her current condition about 4 years ago with pulsatile tinnitus, to which were added progressively: Pain, conjunctival erythema, right eye proptosis and the occasional headache of moderate intensity. Caotid-cavernous fistula wes diagnosed, for the technical difficulty inherent in the case was made a contralateral transvenous approach and embolization with 360° GDG coils, with successful evolution of the patient. The endovascular management of these lesions is currently possible with excellent results.

No MeSH data available.


Related in: MedlinePlus