{Reference Type}: Journal Article
{Title}: Transorbital puncture for the treatment of cavernous sinus dural arteriovenous fistulas.
{Author}: Hughes L;Satchi K;Mitchell P;McNab AA;Hardy TG;
{Journal}: Eur J Ophthalmol
{Volume}: 0
{Issue}: 0
{Year}: 2024 Aug 6
{Factor}: 1.922
{DOI}: 10.1177/11206721241272242
{Abstract}: <B>BACKGROUND: </B>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.<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.