抄録
In this paper, we reported that a carotid-cavernous fistulae (CCF) and a dural arteriovenous malformation (dAVM) were treated by intravascular surgery via the intra-arterial and transvenous routes.
Case 1 A 2-month-old male presented exophthalmos and chemosis of the right eye, and bruit was detected. Ophthalmological findings included proptosis, conjuntival hyperemia, and pulsating exophalmos of the right eye.
Selective external carotid angiography revealed a high flow CCF supplied by an enlarged middle meningeal artery. Drainage from the cavernous sinus to the internal jugular vein was via a distended superior petrosal sinus.
We performed intra-arterial embolization (platinum spring coil ad 4-0 silk thread were used as embolic agents). The symptoms disappeared without complication.
Case 2 A 74-year-old female presented proptosis of the left eye and palsy of the left fourth and sixth cranial nerves.
Bilateral carotid angiography revealed a low flow dAVM in the bilateral cavernous sinuses (CS) supplied by each menigohypophyseal trunk. Drainage from the cavernous sinuses was via the inferior petrosal sinuses (IPS). To facilitate transvenous placement of emboli, catheters were placed in each paired IPS and paired CS via the femoral vein.
Emboli were positioned in each paired CS. The embolic agents used were platinum spring coil and 4-0 silk thread. The neurological deficits disappeared after the operation.
We believe that a high flow external carotid cavernous fistula (Case 1) can be corrected by the intra-arterial route, and also that transvenous embolization of dAVM (Case 2) can be performed safely and with certainty to reduce the risk of arterial embolization.
