Transvenous injection of n-Butyl cyanoacrylate combined with placement of coils in cavernous sinus for treatment of cavernous dural arteriovenous fistulae

• Published in: Journal of Medical Colleges of PLA 2010, Vol.25 (5), p.285-292
• Main Authors: Huairui, Chen, Ruilin, Bai, Xiaojun, Wu, Qiyong, Mei, Chenran, Zhang, Yicheng, Lu
• Format: Article
• Language: English
• Subjects: Cavernous sinus; Dural arteriovenous fistula; Embolization; Glue; 丙烯酸正丁酯; 临床治疗; 海绵状; 海绵窦; 静脉注射
• ISSN: 1000-1948
• DOI: 10.1016/S1000-1948(11)60014-2

Objective： To evaluate the technical aspects, efficacy and safety in the treatment of cavernous dural arteriovenous fistulae （DAVF） by transvenous liquid n-Butyl cyanoacrylate （NBCA） injection combined with coils placement in the cavemous sinus. Methods： Eight patients with cavernous DAVF, treated by transvenous embolization with combination of detachable coils and glue between February 2006 and February 2009 in our hospital, were retrospectively analyzed, including the clinical presentations, patterns of angioarchitecture, methods of treatment and the results of follow-up. Results： In all 8 patients, 9 transvenous and 1 transarterial interventions were carried out. A single endovascular procedure was performed in 6 patients and 2 patients had to be treated twice. Of the nine transvenous approaches, eight approaches were performed via inferior petrosal sinus （IPS） and 1 via the facial vein. Complete angiographic obliteration was achieved in all patients immediately after the embolization. There was no procedure-related morbidity except for mild headache for one to seven days after the embolization. Clinical cure was achieved in all cases during the clinical follow-up periods, ranging from 8 months to 3 years. The follow-up angiography periods averaged 6.6 months with a range of 5-9 months, in which no recurrence was observed. Conclusion： In this small series, embolization with combination of glue and detachable coils by transvenous approaches was a safe, effective and economical method for the treatment of part of symptomatic patients presenting with complex cavernous DAVE