Intravascular Treatment Of Dural Arteriovenous Fistula In The Cavernous Sinus Region

Objective: To explore the safety and effectiveness of intravascular embolization for the patients with cavernous sinus dural arteriovenous fistula(CS-DAVF)based on ocular symptoms.Methods: To analyze the clinical and imaging data of 38 patients with CS-DAVF from January 2010 to October 2017 in Department of Neurosurgery,the First Affiliated Hospital of Xinjiang Medical University.Among them,there were 18 cases of arterial approach,12 cases via venous approach,8 cases of arteriovenous combined approach,20 cases with Onyx-18 glue embolism,and 18 cases with Onyx-18 glue combined with coils.The average duration of their follow-up was 15.1 months(6-30 months).The follow-up included the eye symptoms and the results of cerebral angiography.Results: The immediate angiography after embolization showed that 31 cases(81.6%)were completely embolized and 7 cases were subtotal embolism.In 2 cases,the problem of temporary bradycardia occurred during the operation,and symptomatic treatment was given during the operation.4 cases had ipsilateral abduction nerve palsy,and 2 cases had an abnormal ipsilateral visual acuity.After the follow-up,35 cases(92.1%)were cured and 3 cases were improved.Complications of transient operation included blurred vision,abducens nerve palsy and exophthalmos.The operative complications of patients were relieved within 2-3 weeks after operation,without recurrence.Conclusion: After the follow-up,the early postoperative symptoms of the patients were relieved,and the method of intravascular embolization for the treatment of CS-DAVF with eye disease was safe and effective.