Inferior Ophthalmic Vein-Dominant Dural Cavernous Fistula Embolization via Combined Orbitotomy and Direct Puncture of Inferior Ophthalmic Vein: A Case Report and Literature Review.

Item request has been placed! ×
Item request cannot be made. ×
loading   Processing Request
Read More Add to Saved list
  • Additional Information
    • Source:
      Publisher: Lippincott Williams & Wilkins for the American Society of Ophthalmic Plastic and Reconstructive Surgery Country of Publication: United States NLM ID: 8508431 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1537-2677 (Electronic) Linking ISSN: 07409303 NLM ISO Abbreviation: Ophthalmic Plast Reconstr Surg Subsets: MEDLINE
    • Publication Information:
      Publication: 199 - : Hagerstown, MD : Lippincott Williams & Wilkins for the American Society of Ophthalmic Plastic and Reconstructive Surgery
      Original Publication: [New York, NY : Raven Press Publishers], c1985-
    • Subject Terms:
      Embolization, Therapeutic*/methods ; Orbit*/blood supply ; Punctures*/methods ; Carotid-Cavernous Sinus Fistula*/therapy ; Carotid-Cavernous Sinus Fistula*/diagnosis ; Carotid-Cavernous Sinus Fistula*/surgery; Humans ; Male ; Middle Aged ; Veins/surgery ; Ophthalmologic Surgical Procedures/methods
    • Abstract:
      Dural carotid-cavernous fistulas (DCF) typically drain into the superior ophthalmic vein. Predominant involvement of the inferior ophthalmic vein (IOV) is rare, with only 4 documented cases in the literature. Here, the authors describe a case of a 51-year-old man who presented with acute left-sided proptosis, dysmotility, and vision loss and was found to have an IOV-dominant type D dural carotid-cavernous fistulas. The fistula could not be embolized by transfemoral endovascular access or orbitotomy alone and was ultimately managed with combined orbitotomy and direct IOV puncture. All previous reports of IOV-dominant dural carotid-cavernous fistulas in the literature were similarly inaccessible via the transfemoral approach. This case highlights the challenges of IOV cutdown and proposes an alternative management strategy. When IOV cutdown is precluded by the fragile, collapsed, or deep nature of the vessel, conversion to percutaneous IOV puncture may offer a safe and effective approach and mitigate the risks of direct puncture alone.
      Competing Interests: A.M.M. is a Consultant for CereVasc Inc., LLC and Cerus Endovascular Ltd. Other authors have no financial or conflicts of interest to disclose.
      (Copyright © 2024 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.)
    • References:
      Oono S, Matsui Y, Saito I, et al. Dural carotid-cavernous fistula successfully treated by embolization via inferior ophthalmic vein: case report. Neuro-Ophthalmology. 1998;20:69–74.
      Michels KS, Ng JD, Falardeau J, et al. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein. Ophthalmic Plast Reconstr Surg. 2007;23:480–482.
      White JB, Layton KF, Evans AJ, et al. Transorbital puncture for the treatment of cavernous sinus dural arteriovenous fistulas. Am J Neuroradiol. 2007;28:1415–1417.
      Cecchini MM, Levitt MR, Taneja M, et al. Embolization of carotid-cavernous fistula via direct percutaneous puncture of the inferior ophthalmic vein. J Neuroradiol. 2012;39:181–185.
      Travers B. A Case of aneurism by anastomosis in the orbit, cured by the ligature of the common carotid artery. Med Chir Trans. 1811;2:1–420.1.
      Azzam DB, Cypen SG, Conger JR, et al. Carotid-cavernous sinus fistula masquerading as thyroid eye disease. Cureus. 2021;13:e14261.
      Lang M, Habboub G, Mullin JP, et al. A brief history of carotid-cavernous fistula. J Neurosurg. 2017;126:1995–2001.
      Phan K, Xu J, Leung V, et al. Orbital approaches for treatment of carotid cavernous fistulas: a systematic review. World Neurosurg. 2016;96:243–251.
      Leibovitch I, Modjtahedi S, Duckwiler GR, et al. Lessons learned from difficult or unsuccessful cannulations of the superior ophthalmic vein in the treatment of cavernous sinus dural fistulas. Ophthalmology. 2006;113:1220–1226.
      Teng MMH, Lirng JF, Chang T, et al. Embolization of carotid cavernous fistula by means of direct puncture through the superior orbital fissure. Radiology. 1995;194:705–711.
    • Publication Date:
      Date Created: 20240509 Date Completed: 20240906 Latest Revision: 20240927
    • Publication Date:
      20240928
    • Accession Number:
      10.1097/IOP.0000000000002698
    • Accession Number:
      38722765