Journal of neurointerventional surgery · 2026
Comparison of superior ophthalmic vein approach and inferior petrosal sinus recanalization in the treatment of cavernous sinus dural arteriovenous fistula: a multicenter retrospective study.
СтатьяМногоцентровое исследованиеСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Zheng Jingwei, Su Shixing, Lu Hua, Liu Sheng, Zhou Shengjun, Jia Qi, Bao Xiang, Li Zhenqiang, Zhou Haihang, Zhang Guoqiang, Jiang Zhijie, Liu Fei, Hu Si, Wang Zixin, Yu Jun, Xu Liang
Аннотация
BACKGROUND: Cavernous sinus dural arteriovenous fistulas (CS-DAVFs) present significant treatment challenges when the inferior petrosal sinus (IPS) is not opacified during cerebral angiography. The consistently visible superior ophthalmic vein (SOV) offers a promising alternative, though it has yet to be fully evaluated in large-scale studies.
METHODS: This retrospective, case-control study was conducted between May 2017 and October 2024. Data collection for this multicenter, population-based study took place across eight tertiary referral centers. Eligible patients diagnosed with CS-DAVF and non-visualized IPS were treated either via the transvenous SOV approach or the IPS recanalization approach.
RESULTS: Of 178 eligible cases, 70 cases (39.33%) were treated using the transvenous SOV approach, while 108 cases (60.67%) underwent the transvenous IPS approach. The initial treatment success rate was significantly higher in the SOV group compared with the IPS group (91.43% vs 75.93%; OR 3.38, 95% CI 1.30 to 8.35, P=0.01). The overall complication rate was 1.43% in the SOV group and 2.78% in the IPS group (OR 0.51, 95% CI 0.04 to 3.47, P>0.99). After classifying the SOV approach into simple and complex types, the SOV-simple type further demonstrated significant advantages, including shorter average operation times (126.20±46.99 min, P=0.02) and a higher initial treatment success rate (95.65%, P=0.003) compared with the IPS group.
CONCLUSION: The SOV approach is recommended as a first-line treatment for CS-DAVF patients with 'invisible' IPS.
METHODS: This retrospective, case-control study was conducted between May 2017 and October 2024. Data collection for this multicenter, population-based study took place across eight tertiary referral centers. Eligible patients diagnosed with CS-DAVF and non-visualized IPS were treated either via the transvenous SOV approach or the IPS recanalization approach.
RESULTS: Of 178 eligible cases, 70 cases (39.33%) were treated using the transvenous SOV approach, while 108 cases (60.67%) underwent the transvenous IPS approach. The initial treatment success rate was significantly higher in the SOV group compared with the IPS group (91.43% vs 75.93%; OR 3.38, 95% CI 1.30 to 8.35, P=0.01). The overall complication rate was 1.43% in the SOV group and 2.78% in the IPS group (OR 0.51, 95% CI 0.04 to 3.47, P>0.99). After classifying the SOV approach into simple and complex types, the SOV-simple type further demonstrated significant advantages, including shorter average operation times (126.20±46.99 min, P=0.02) and a higher initial treatment success rate (95.65%, P=0.003) compared with the IPS group.
CONCLUSION: The SOV approach is recommended as a first-line treatment for CS-DAVF patients with 'invisible' IPS.