Efficacy of a unique straight, conformable, bare platinum coil in the treatment of cavernous sinus dural arteriovenous fistula

摘要

In embolization of a cavernous sinus (CS) by transvenous embolization (TVE) for a CS dural arteriovenous fistula (DAVF), selection of embolization coils is difficult owing to the complex anatomical structure of the CS. Moreover, overpacking of the CS with embolization coils may cause permanent cranial nerve palsies. The ED coil-10 (EDC-10) infini is an extremely soft platinum coil without shape-memory that has excellent conformability with surrounding structures. The goal of this study was to evaluate use of the EDC-10 infini coil for embolization of a CS DAVF. Six patients with a CS DAVF were treated with TVE. Refluxing cerebral and ophthalmic veins were embolized with shape-memory type coils other than EDC-10 infini, and CSs were embolized with the EDC-10 infini coils. In five cases, CSs were loosely embolized with EDC-10 infini coils. In one case, reflux of the cerebral vein worsened from the CS during the procedure, and embolization of the CS tightly using three-dimensional shape-memory type coils other than EDC-10 infini. Overall, three to 19 (average 7.3) coils were used fozr each CS and the total coil volume was 33-284 (average 95.1) mm(3) in each CS. Postoperative transient abducens palsy occurred in two cases, but both patients recovered completely. There was no case of recurrence.