Transvenous embolization of cavernous dural arteriovenous fistulas

Objective To present the results of treatment of cavernous dural arteriovenous fistulas via the transvenous approach. Methods The involved cavernous sinuses were catheterized via femoral vein -inferior petrosal sinus approach or femoral vein -facial vein -superior opthalmic vein approach, and embolized with coils ( GDC, EDC or free coil) or coils and silk. Results 17 cavernous sinuses in 13 patients with cavernous dural arteriovenous fistulas were embolized. Immediate complete angiographic obliteration of the fistulas was achieved in 10 patients. Residual shunting was left in 3 patients, 2 with pteroid drainage and 1 with inferior petrosal sinus drainage. Headache and vomitting were the most common symptoms after embolization. The follow-up period ranged from 3 months to 26 months. Clinical cure was achieved in 10 of 13 patients. Angiography at the third month after emboli zation was performed in 3 patients with residual shunting, angiographic. cure in 2, residual pteriod drainage in 1. Follow-up angiography was not performed in other patients. Conclusion Transvenous catheterization and embolization of cavernous sinus was a safe and effective way to treat cavernous dural arteriovenous fistulas.