Abstract
Objective: Transvenous embolization using coils is one of the standard treatment options for cavernous sinus dural arteriovenous fistulas (CS dAVFs). However, complete obliteration is not always obtained by transvenous coil embolization alone. We report here three patients treated by transvenous infusion of n-butyl cyanoacrylate (n-BCA), and discuss the technical aspects, safety and efficacy of this technique.
Method: Two patients presented with ocular symptoms and one with intracerebral hemorrhage. Affected CS was accessed via transfemoral-inferior petrosal sinus route in all patients. One patient was treated with transvenous n-BCA infusion alone and two patients with transvenous n-BCA infusion after coil embolization.
Result: Complete obliteration was achieved in two patients, and reduction of the shunt with obliteration of a dangerous drainage in one patient. No complications associated with the procedures were observed in any of the patients.
Conclusion: Transvenous n-BCA infusion is an effective alternative in CS dAVFs refractory to transvenous coil embolization.
