Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein

Kevin S. Michels, John D. Ng, Julie Falardeau, Warren G. Roberts, Bryan Petersen, Gary M. Nesbit, Stanley L. Barnwell

Research output: Contribution to journalArticle

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A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

Original languageEnglish (US)
Pages (from-to)480-482
Number of pages3
JournalOphthalmic plastic and reconstructive surgery
Issue number6
StatePublished - Nov 1 2007


ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

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