Transvenous injection of n-butyl 2-cyanoacrylate to obliterate the pathologic cavernous sinus as a salvage technique for incompletely obliterated complex cavernous sinus dural arteriovenous fistula after transvenous coil embolization.

Abstract

A Barrow type D of complex cavernous sinus dural arteriovenous fistula (CS-dAVF) was completely obliterated by using coils, n-butyl 2-cyanoacrylate (NBCA) and Onyx via transvenous approach. Especially in this case, after transvenous coil embolization of the pathologic cavernous sinus (CS), transvenous injection of NBCA was done to obliterate residual shunts recruited into CS. The complex CS-dAVF was completely obliterated without periprocedural complications. Transvenous injection of NBCA could be considered as a feasible option for obliteration of pathologic CS in a case of incompletely obliterated complex CS-dAVF after transvenous coil embolization.