Results of Transvenous Embolization of Cavernous Dural Arteriovenous Fistula: A Single-Center Experience with Emphasis on Complications and Management

A 60-year-old man presented with symptoms of decreased visual acuity, exophthalmos, and chemosis of the left eye of 1 month’s duration.

A, Initial left ICA angiogram revealed an arteriovenous shunt at the left cavernous sinus with drainage into the superior ophthalmic and inferior ophthalmic veins.

B, Transvenous coil embolization of the left cavernous sinus was performed via a left SOV approach, resulting in nearly complete occlusion of the target sinus with slow but stagnant flow in the anterior pontomesencephalic veins (arrows).

C, Fluid-attenuated inversion recovery images of the patient after he developed mild dysarthria shows congestion of the brain stem. Bilateral graft stents were deployed for occlusion of the residual meningohypophyseal feeders.

D, Poststent left ICA angiogram shows complete occlusion of the residual shunt.