A Case of Orbital Dural Arteriovenous Fistula with Exophthalmos Treated by Transarterial Embolization

Abstract

Objective: Transarterial embolization (TAE) for dural arteriovenous fistula (dAVF) is sometimes risky because of dangerous anastomosis. We successfully treated orbital apex dAVF by blocking back-flow to the internal carotid artery and ophthalmic artery with coil and balloon. Case Presentation: A 51-year-old man had red right eye and exophthalmos, and was diagnosed with right orbital apex dAVF. TAE using n-butyl-2-cyanoacrylate (NBCA)/lipiodol mixture via the artery of the superior orbital fissure was performed under flow control of the internal carotid artery and ophthalmic artery with balloon microcatheter and temporary placing of detachable coil. After the treatment, the shunt disappeared and the symptoms were improved. Conclusion: A proper understanding of dangerous anastomosis is important for safe and effective use of TAE for dAVF.