Abstract：
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
摘要：
背景：颈动脉-海绵窦硬脑膜动静脉瘘（CCF）的血管内栓塞最常见的是经股静脉入路。手术切除眼上静脉是一种替代方法，描述良好的路线。当这些被证明无法访问时，经眶入路可用于到达瘘管。
方法：我们描述了最近的经验-包括适应症，外科技术,放射学发现和术后结果-在墨尔本的一系列患者中，经皮，经眶直接穿刺海绵窦可以成功栓塞硬脑膜动静脉瘘。
结果：3例患者均通过经眶穿刺成功栓塞CCF。术后,所有患者均经历了症状缓解,其CCF继发的临床体征完全缓解.
结论：当血管构筑不允许血管内通路时，经眶穿刺颈动脉海绵窦硬脑膜动静脉瘘是一种安全有效的技术。该报告支持其成功和低并发症发生率。
方法：我们描述了最近的经验-包括适应症，外科技术,放射学发现和术后结果-在墨尔本的一系列患者中，经皮，经眶直接穿刺海绵窦可以成功栓塞硬脑膜动静脉瘘。
结果：3例患者均通过经眶穿刺成功栓塞CCF。术后,所有患者均经历了症状缓解,其CCF继发的临床体征完全缓解.
结论：当血管构筑不允许血管内通路时，经眶穿刺颈动脉海绵窦硬脑膜动静脉瘘是一种安全有效的技术。该报告支持其成功和低并发症发生率。
