Clinical Analysis Of The Undeveloped Embolization Of The Cavernous Sinus In The Patients Of Petrosal Sinus Dural Arteriovenous Fistula

Objective:To evaluate the opening rate of rock sinus , the clinical efficency and clinical considerations of the undeveloped rock embolization cavernous sinus in the patients of dural arteriovenous fistula.Methods:Retrospective and summarize the cilical data of 28 dural arteriovenous fistula cases who were treatmented by venous sinus thrombosis in our hospital from 2005 to 2011 All patients underwent cerebral angiography in the case of systemic heparinization and local anesthesia with the Seldinger intubation technique through the femoral artery to got a comprehensive understanding about the site,characters,size, feeding arteries , and other forms of venous drainage of the fistula. Probe the undeveloped petrosal sinus fistula via femoral vein in the initial segment of the internal jugular vein and thromb the DAVF after reaching the cavernous sinus fistula . If the blood flow be slower, thromb the fistula by Onyx18 glue directly. If the blood flow faster, thromb the fistula with coil embolization firstly, when the blood flow slows down ,then thromb the fistula using Onyx18 further more. Observed the opening rate of inferior petrosal sinus, the success rate, safety and efficiency of this method. And followed the cases through clinics, telephone or DSA 6 months later.Results:Most patients had no sever postoperative complications after the surgery. One patient had subarachnoid hemorrhage.28 cases had no deaths. The sinus opened in 27 cases, placing the tube smoothly , and had venous thrombosis succesfully. Implemented angiography immediately after embolization, had no early draining veins, the fistula disappeared, reaching the radiographic healing. The opening rate of the undeveloped petrosal sinus was 96%. The symptoms of one cases who failed in placing tube improved after the treatment of ophthalmic vein thrombosis. All cases were followed up 6months later after the surgery,had no recurrence.The clinical symptoms improved or disappear in all patients.Conclusion:The treatment of the undeveloped rock embolization cavernous sinus DAVF has highe opening rate , feasibility, safety and efficiency wich can be used as the first choice for the cavernous sinus DAVF. Endovascular embolization of DAVF has some complications. But complications can be prevented by careful analysis of preoperative data and careful operation.