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

Interv Neuroradiol. 2015 Jun;21(3):362-5. doi: 10.1177/1591019915581945. Epub 2015 May 14.

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; embolization; inferior petrosal sinus.

Publication types

  • Case Reports

MeSH terms

  • Cavernous Sinus / diagnostic imaging*
  • Central Nervous System Vascular Malformations / diagnostic imaging*
  • Central Nervous System Vascular Malformations / therapy*
  • Cerebral Angiography*
  • Contrast Media
  • Cranial Sinuses / diagnostic imaging*
  • Diagnosis, Differential
  • Embolization, Therapeutic / methods*
  • Humans
  • Imaging, Three-Dimensional*
  • Iopamidol / analogs & derivatives
  • Male
  • Middle Aged
  • Phlebography
  • Radiography, Interventional*

Substances

  • Contrast Media
  • iomeprol
  • Iopamidol