Superior ophthalmic vein approach to carotid-cavernous fistulas. Technical note.

Endovascular procedures have revolutionized the treatment of carotid-cavernous fistulas through transarterial and transvenous routes. In some circumstances, however, traditional endovascular approaches may fail. Direct access to the superior ophthalmic vein (SOV) can be used to treat fistulas in this circumstance. The authors discuss the technical aspects of direct exposure of the SOV for access to the cavernous sinus.