Ophthalmologic outcome of transvenous embolization of spontaneous carotid-cavernous fistulas: a preliminary report.

We give a preliminary report of the ophthalmologic outcome of four patients with transvenous embolization studied for their spontaneous carotid-cavernous fistulas. One of them is a direct type while three of them are indirect dural shunts. In indirect dural shunts, traditional transarterial embolization rarely achieves a complete clinical cure in a short period of time. All cases had an ophthalmologic disturbance justified for endovascular intervention. We performed catheterization, and subsequently embolization with Guglielmi Detachable coils, to the cavernous sinus via the femoral vein and inferior petrosal sinus/superior ophthalmic vein. All four patients achieved clinical and angiographic improvement with a follow-up period range from two to sixteen months except for one patient who had residual bilateral sixth nerve palsy. The transvenous approach offers an effective and safe alternative for the management of spontaneous carotid-cavernous fistula.