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Acute Exophthalmos During Treatment of a Cavernous Sinus-Dural Fistula Through the Superior Ophthalmic Vein

Acute Exophthalmos During Treatment of a Cavernous Sinus-Dural Fistula Through the Superior... Abstract We read with interest the article by Goldberg et al1 in the June 1996 issue of the Archives and would like to comment on the importance of ophthalmologic monitoring during the procedure to detect and treat vision-threatening increases in orbital pressure. We recently treated a 35-year-old white man with a spontaneous cavernous sinus-dural fistula. An arteriogram demonstrated poor venous access through the usual transcutaneous approaches. We were asked to provide access for a superior ophthalmic vein cannulation. An anterior orbitotomy was performed while the patient was under general anesthesia, and the superior ophthalmic vein was isolated. A micropuncture introducer (4F Micropuncture Introducer, Cook Corp, Bloomington, Ind) was introduced. A microcatheter (Tracker-18, Target Therapeutics, Fremont, Calif) was placed through the introducer into the posterior cavernous sinus. Platinum microcoils were passed into the sinus. Approximately 1 hour after commencement of the procedure, increasing exophthalmos of the right eye was noted, along References 1. Goldberg RA, Goldey SH, Duckwiler G, Vinnuela F. Management of cavernous sinus-dural fistulas: indications and techniques for primary embolization via the superior ophthalmic vein . Arch Ophthalmol . 1996;114:707-714.Crossref 2. Kupersmith MJ. Neurovascular Neuro-Ophthalmology . New York, NY: Springer-Verlag NY Inc; 1993:102,139-140. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Acute Exophthalmos During Treatment of a Cavernous Sinus-Dural Fistula Through the Superior Ophthalmic Vein

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Publisher
American Medical Association
Copyright
Copyright © 1997 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1997.01100150825035
Publisher site
See Article on Publisher Site

Abstract

Abstract We read with interest the article by Goldberg et al1 in the June 1996 issue of the Archives and would like to comment on the importance of ophthalmologic monitoring during the procedure to detect and treat vision-threatening increases in orbital pressure. We recently treated a 35-year-old white man with a spontaneous cavernous sinus-dural fistula. An arteriogram demonstrated poor venous access through the usual transcutaneous approaches. We were asked to provide access for a superior ophthalmic vein cannulation. An anterior orbitotomy was performed while the patient was under general anesthesia, and the superior ophthalmic vein was isolated. A micropuncture introducer (4F Micropuncture Introducer, Cook Corp, Bloomington, Ind) was introduced. A microcatheter (Tracker-18, Target Therapeutics, Fremont, Calif) was placed through the introducer into the posterior cavernous sinus. Platinum microcoils were passed into the sinus. Approximately 1 hour after commencement of the procedure, increasing exophthalmos of the right eye was noted, along References 1. Goldberg RA, Goldey SH, Duckwiler G, Vinnuela F. Management of cavernous sinus-dural fistulas: indications and techniques for primary embolization via the superior ophthalmic vein . Arch Ophthalmol . 1996;114:707-714.Crossref 2. Kupersmith MJ. Neurovascular Neuro-Ophthalmology . New York, NY: Springer-Verlag NY Inc; 1993:102,139-140.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jun 1, 1997

References