Transvenous embolization of cavernous sinus dural arteriovenous fistula through a thrombosed inferior petrosal sinus utilizing 3D venography

Abstract

Objective

We report a new technique in approaching the cavernous sinus through an occluded inferior petrosal sinus (IPS) using three-dimensional (3D) venography.

Case presentation

A patient diagnosed with arteriovenous fistula of the right cavernous sinus underwent transvenous embolization. The IPS was not detectable on angiogram. Retrograde injection of contrast with 3D imaging of the internal jugular vein clearly demonstrated the remnant of the IPS. By referring to the images obtained, catheterization of the cavernous sinus by way of the IPS was performed without difficulties.

Conclusion

Three-dimensional venography for detecting the entrance to the IPS is a useful method and easy to perform. We believe that this technique should be considered whenever the access to an occluded IPS is necessary.

Keywords

Cavernous sinus dural arteriovenous fistula inferior petrosal sinus embolization

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References

Halbach

Higashida

Hieshima

. Transvenous embolization of dural fistulas involving the cavernous sinus. AJNR Am J Neuroradiol 1989; 10(2): 377–383.

Kim

Suh

. Results of transvenous embolization of cavernous dural arteriovenous fistula: a single-center experience with emphasis on complications and management. AJNR Am J Neuroradiol 2006; 27(10): 2078–2082.

Mitsuhashi

Nishio

Kawahara

. Morphologic evaluation of the caudal end of the inferior petrosal sinus using 3D rotational venography. AJNR Am J Neuroradiol 2007; 28(6): 1179–1184.

Benndorf

Bender

Lehmann

. Transvenous occlusion of dural cavernous sinus fistulas through the thrombosed inferior petrosal sinus: report of four cases and review of the literature. Surg Neurol 2000; 54(1): 42–54.

Tubbs

Watanabe

Loukas

. Anatomy of the inferior petro-occipital vein and its relation to the base of the skull: Application to surgical and endovascular procedures of the skull base. Clin Anat 2014; 27(5): 698–701.

Kurata

Suzuki

Iwamoto

. A new transvenous approach to the carotid-cavernous sinus via the inferior petrooccipital vein. J Neurosurg 2012; 116(3): 581–587.

Quinones

Duckwiler

Gobin

. Embolization of dural cavernous fistulas via superior ophthalmic vein approach. AJNR Am J Neuroradiol 1997; 18(5): 921–928.

Shiu

Hanafee

Wilson

. Cavernous sinus venography. Am J Roentgenol Radium Ther Nucl Med 1968; 104(1): 57–62.

Mounayer

Piotin

Spelle

. Superior petrosal sinus catheterization for transvenous embolization of a dural carotid cavernous sinus fistula. AJNR Am J Neuroradiol 2002; 23(7): 1153–1155.

10.

Chun

Tomsick

. Transvenous embolization of a direct carotid cavernous fistula through the pterygoid plexus. AJNR Am J Neuroradiol 2002; 23(7): 1156–1159.

11.

Oishi

Arai

Sato

. Complications associated with transvenous embolisation of cavernous dural arteriovenous fistula. Acta Neurochir (Wien) 1999; 141(12): 1265–1271.