Orbital, Plastics and Lacrimal Unit, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia.
Eur J Ophthalmol. 2024 Nov;34(6):NP10-NP14. doi: 10.1177/11206721241272242. Epub 2024 Aug 6.
Endovascular embolization of carotid-cavernous sinus dural arteriovenous fistulas (CCFs) is most commonly performed via a transfemoral-transvenous approach. Surgical cut-down of the superior ophthalmic vein is an alternative, well-described route. When these prove inaccessible, a transorbital approach can be used to reach the fistula.
We describe the recent experience- including indications, surgical technique, radiological findings and post-operative outcomes- in Melbourne of a series of patients in whom a percutaneous, transorbital direct puncture of the cavernous sinus enabled successful embolization of dural arteriovenous fistulas.
Each of three patients achieved successful embolization of their CCFs via a transorbital puncture. Post-operatively, all patients experienced symptomatic relief with complete resolution of clinical signs secondary to their CCFs.
When angioarchitecture does not allow endovascular access, transorbital puncture of carotid-cavernous sinus dural arteriovenous fistulas can be a safe and effective technique. This report supports its success and low complication rate.
颈内动脉海绵窦段硬脑膜动静脉瘘（CCF）的血管内栓塞治疗最常通过股静脉入路进行。手术切开眼上静脉也是一种可行的、有充分描述的入路。如果这些方法不可行，可以采用经眶入路到达瘘口。
我们描述了在墨尔本，最近一系列患者的经验，包括适应证、手术技术、影像学发现和术后结果，这些患者通过经皮、经眶直接穿刺海绵窦成功地栓塞了硬脑膜动静脉瘘。
三位患者中的每一位都通过经眶穿刺成功地栓塞了他们的 CCF。术后，所有患者的 CCF 相关症状均得到缓解，临床体征完全消退。
当血管解剖结构不允许血管内入路时，经眶穿刺海绵窦硬脑膜动静脉瘘可以是一种安全有效的技术。本报告支持其成功率和低并发症发生率。
