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Results of Transvenous Embolization of Cavernous Dural Arteriovenous Fistula: A Single-Center Experience with Emphasis on Complications and Management

 D.J. Kim  ;  D.I. Kim  ;  S.H. Suh  ;  J. Kim  ;  S.K. Lee  ;  E.Y. Kim  ;  T.S. Chung 
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.27(10) : 2078-2082, 2006 
Journal Title
Issue Date
Adult ; Aged ; Central Nervous System Vascular Malformations/therapy* ; Embolization, Therapeutic/adverse effects* ; Embolization, Therapeutic/methods* ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies
BACKGROUND AND PURPOSE: To describe the results of transvenous embolizations of cavernous dural arteriovenous fistua (cDAVF) with an emphasis on identifying the incidence, characteristics, and management strategies associated with the complications of transvenous embolization of cDAVFs. METHODS: Fifty-six consecutive patients who were treated by transvenous embolization for cDAVFs were reviewed. The approach routes, angiographic results, complications, and clinical outcome were assessed. RESULTS: Retrograde inferior petrosal sinus (n = 36), transfacial vein (n = 7), transcontralateral intercavernous sinus (n = 4), and direct superior ophthalmic vein (n = 3) approaches were used. Angiographic results showed complete occlusion (n = 29), nearly complete occlusion (n = 13), and incomplete occlusion (n = 14). Complications associated with the procedures were cranial nerve palsy (n = 6), venous perforation (n = 3), and brain stem congestion (n = 2). The cranial nerve signs resolved with conservative treatment. Venous perforations were managed by coil embolizations at the site of the tear with no significant neurologic sequelae. One case of brain stem congestion resulted in hemiplegia after conservative treatment. The other case showed venous congestion as a result of rerouting of the shunted flow after venous embolization that was successfully managed by covered stent deployment for occlusion of the residual feeders. Clinical follow-up data were available in 46 patients. Complete resolution or improvement of symptoms was seen in 42 patients (91%). CONCLUSIONS: Cavernous DAVFs may be effectively treated by transvenous embolization. However, the procedure can be associated with various complications, some of which can potentially result in significant morbidity. Prompt diagnosis of the complications with appropriate management strategies is mandatory for a safe procedure.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Eung Yeop(김응엽)
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Chung, Tae Sub(정태섭)
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