Embolization of the dural carotid-cavernous fistulas within the cavernous sinus by using glue and detachable coils via a venous access

Objective: To explore the method and strategy of occluding the dural carotid-cavernous fistulas within the cavernous sinus by using glue and detachable coils via a venous access. Methods: A total of 8 patients with dural carotid-cavernous fistulas were treated with transvenous embolization by using detachable coils and glue as embolic agents. The medical data, including the clinical manifestations, the angio-architecture features of the fistula orifice,the methods of treatment and the therapeutic results were retrospectively analyzed. Results: The interventional procedures were completed via venous approaches in all patients. The venous access included facial-superior ophthalmic vein (n = 1) and inferior petrosal sinus(n = 7). Clinical complete cure was obtained in all eight patients. Angiography immediately after the treatment showed that the fistula orifice was obliterated in all cases. No procedure-related complications occurred except for mild headache for one to three days after the embolization. The patients had no recurrence during a followup period of 3-36 months. Conclusion: Interventional embolization by using glue and detachable coils via a venous access is an effective, economical and safe treatment for the dural carotid-cavernous fistulas within the cavernous sinus. (authors)