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<meta name="DC.Title" content="Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2040" />
<meta name="DC.Date" content="2010-08-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Cranial nerve palsies are regularly observed in patients with arteriovenous fistulas of the cavernous sinus. The purpose of our study was to determine the long-term clinical outcome—with a special focus on extra-ocular muscular dysfunctions—in patients who had undergone endovascular treatment of a cavernous sinus fistula with detachable coils.

MATERIALS AND METHODS: Sixteen patients were recalled for an ophthalmoneurologic control examination (mean interval of 4.4 years). The mRS and the EQ-5D questionnaire were used for the description of general outcome. Age, duration of symptoms, character of the fistula (direct, dural), and coil volume were tested to assess their relevance for persistent symptoms.

RESULTS: All patients displayed complete regression of chemosis, exophthalmus, and pulsating tinnitus with no evidence of recurrences. Oculomotor disturbances persisted in 9 of 13 patients and caused permanent diplopia in 7 patients. In 15 patients a mRS score of 1 or 2 was achieved; however, 7 patients reported some limitations in life quality (EQ-5D). A significant correlation was found between coil volume and persistent diplopia ( P = .032) and persistent cranial nerve VI paresis ( P = .037).

CONCLUSIONS: Coil embolization of the cavernous sinus led to durable closure of AVF and reliable regression of acute symptoms. However, long-term follow-up showed a 44% rate of persistent cranial nerve deficits with disturbances of oculomotor and visual functions. This may be explained by the underlying fistula size itself and/or the space-occupying effect of the coils. As neuro-ophthalmologic outcome is crucial for control of therapeutic success, patients should be routinely examined by ophthalmologists.

AVF
:   arteriovenous fistula
CNP
:   cranial nerve palsies
CS
:   cavernous sinus
ICA
:   internal carotid artery
LR
:   likelihood ratio
mRS
:   modified Rankin Scale
na
:   not available
SOV
:   superior ophthalmic vein" />
<meta name="DC.Contributor" content="A. Bink" />
<meta name="DC.Contributor" content="K. Goller" />
<meta name="DC.Contributor" content="M. Lüchtenberg" />
<meta name="DC.Contributor" content="T. Neumann-Haefelin" />
<meta name="DC.Contributor" content="S. Dützmann" />
<meta name="DC.Contributor" content="F. Zanella" />
<meta name="DC.Contributor" content="J. Berkefeld" />
<meta name="DC.Contributor" content="R. du Mesnil de Rochemont" />
<meta name="article:published_time" content="2010-08-01" />
<meta name="article:section" content="Interventional" />
<meta name="citation_title" content="Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE: &lt;/h3&gt;
&lt;p&gt;Cranial nerve palsies are regularly observed in patients with arteriovenous fistulas of the cavernous sinus. The purpose of our study was to determine the long-term clinical outcome—with a special focus on extra-ocular muscular dysfunctions—in patients who had undergone endovascular treatment of a cavernous sinus fistula with detachable coils.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS: &lt;/h3&gt;
&lt;p&gt;Sixteen patients were recalled for an ophthalmoneurologic control examination (mean interval of 4.4 years). The mRS and the EQ-5D questionnaire were used for the description of general outcome. Age, duration of symptoms, character of the fistula (direct, dural), and coil volume were tested to assess their relevance for persistent symptoms.&lt;/p&gt;&lt;h3&gt;RESULTS: &lt;/h3&gt;
&lt;p&gt;All patients displayed complete regression of chemosis, exophthalmus, and pulsating tinnitus with no evidence of recurrences. Oculomotor disturbances persisted in 9 of 13 patients and caused permanent diplopia in 7 patients. In 15 patients a mRS score of 1 or 2 was achieved; however, 7 patients reported some limitations in life quality (EQ-5D). A significant correlation was found between coil volume and persistent diplopia (&lt;i&gt;P&lt;/i&gt; = .032) and persistent cranial nerve VI paresis (&lt;i&gt;P&lt;/i&gt; = .037).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS: &lt;/h3&gt;
&lt;p&gt;Coil embolization of the cavernous sinus led to durable closure of AVF and reliable regression of acute symptoms. However, long-term follow-up showed a 44% rate of persistent cranial nerve deficits with disturbances of oculomotor and visual functions. This may be explained by the underlying fistula size itself and/or the space-occupying effect of the coils. As neuro-ophthalmologic outcome is crucial for control of therapeutic success, patients should be routinely examined by ophthalmologists.&lt;/p&gt;" />
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<meta name="citation_reference" content="citation_journal_title=European radiology;citation_journal_abbrev=Eur Radiol;citation_author=A. Bink;citation_author=J. Berkefeld;citation_author=M. Lüchtenberg;citation_title=Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula.;citation_pages=1443-1449;citation_volume=19;citation_year=2009;citation_issue=6;citation_pmid=19137301;citation_doi=10.1007/s00330-008-1278-1" />
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<meta name="citation_reference" content="citation_journal_title=Neuroradiology;citation_journal_abbrev=Neuroradiology;citation_author=K. Yamashita;citation_author=W. Taki;citation_author=S. Nishi;citation_title=Transvenous embolization of dural caroticocavernous fistulae: technical considerations.;citation_pages=475-479;citation_volume=35;citation_year=1993;citation_issue=6;citation_pmid=8377926;citation_doi=10.1007/BF00602836" />
<meta name="citation_reference" content="citation_journal_title=Neurosurgery;citation_journal_abbrev=Neurosurgery;citation_author=D. Roy;citation_author=J. Raymond;citation_title=The role of transvenous embolization in the treatment of intracranial dural arteriovenous fistulas.;citation_pages=1133-1141;citation_volume=40;citation_year=1997;citation_issue=6;citation_pmid=9179885;citation_doi=10.1097/00006123-199706000-00004" />
<meta name="citation_reference" content="citation_journal_title=J Neurol Neurosurg Psychiatry ;citation_author=M. Théaudin;citation_author=JP. Saint-Maurice;citation_author=R. Chapot;citation_title=Diagnosis and treatment of dural carotid-cavernous fistulas: a consecutive series of 27 patients;citation_volume=78;citation_year=2007;citation_pmid=17028116;citation_doi=10.1136/jnnp.2006.100776" />
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<meta name="citation_reference" content="citation_journal_title=Health policy (Amsterdam, Netherlands);citation_journal_abbrev=Health Policy;citation_title=EuroQol--a new facility for the measurement of health-related quality of life. The EuroQol Group.;citation_pages=199-208;citation_volume=16;citation_year=1990;citation_issue=3;citation_pmid=10109801;citation_doi=10.1016/0168-8510(90)90421-9" />
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<meta name="citation_reference" content="citation_journal_title=Journal of neurosurgery;citation_journal_abbrev=J Neurosurg;citation_author=F. Viñuela;citation_author=AJ. Fox;citation_author=GM. Debrun;citation_title=Spontaneous carotid-cavernous fistulas: clinical, radiological, and therapeutic considerations. Experience with 20 cases.;citation_pages=976-984;citation_volume=60;citation_year=1984;citation_issue=5;citation_pmid=6716167" />
<meta name="citation_reference" content="citation_journal_title=Surgical neurology;citation_journal_abbrev=Surg Neurol;citation_author=H. Nukui;citation_author=T. Shibasaki;citation_author=M. Kaneko;citation_title=Long-term observations in cases with spontaneous carotid-cavernous fistulas.;citation_pages=543-552;citation_volume=21;citation_year=1984;citation_issue=6;citation_pmid=6719325;citation_doi=10.1016/0090-3019(84)90267-2" />
<meta name="citation_reference" content="citation_journal_title=Radiology;citation_journal_abbrev=Radiology;citation_author=VV. Halbach;citation_author=RT. Higashida;citation_author=GB. Hieshima;citation_title=Dural fistulas involving the cavernous sinus: results of treatment in 30 patients;citation_pages=437-442;citation_volume=163;citation_year=1987;citation_issue=2;citation_issn=0033-8419;citation_pmid=3562823" />
<meta name="citation_reference" content="citation_journal_title=Neuroradiology;citation_journal_abbrev=Neuroradiology;citation_author=HM. Liu;citation_author=YH. Wang;citation_author=YF. Chen;citation_title=Long-term clinical outcome of spontaneous carotid cavernous sinus fistulae supplied by dural branches of the internal carotid artery.;citation_pages=1007-1014;citation_volume=43;citation_year=2001;citation_issue=11;citation_pmid=11760792;citation_doi=10.1007/s002340100621" />
<meta name="citation_reference" content="citation_journal_title=American Journal of Neuroradiology;citation_journal_abbrev=Am. J. Neuroradiol.;citation_author=FY. Tsai;citation_author=GB. Hieshima;citation_author=CM. Mehringer;citation_title=Delayed effects in the treatment of carotid-cavernous fistulas.;citation_pages=357-361;citation_volume=4;citation_year=1983;citation_issue=3;citation_issn=0195-6108;citation_pmid=6410744" />
<meta name="citation_reference" content="citation_journal_title=Acta Radiologica;citation_journal_abbrev=tempActa Radiol;citation_author=B. Berthelsen;citation_author=P. Svendsen;citation_title=Treatment of direct carotid-cavernous fistulas with detachable balloons.;citation_pages=683-691;citation_volume=28;citation_year=1987;citation_issue=6;citation_issn=temp0284-1851;citation_pmid=2962600;citation_doi=10.3109/02841858709177424" />
<meta name="citation_reference" content="citation_journal_title=Journal of Neurology, Neurosurgery &amp; Psychiatry;citation_journal_abbrev=J. Neurol. Neurosurg. Psychiatry;citation_author=D. Brosnahan;citation_author=RM. McFadzean;citation_author=E. Teasdale;citation_title=Neuro-ophthalmic features of carotid cavernous fistulas and their treatment by endoarterial balloon embolisation.;citation_pages=553-556;citation_volume=55;citation_year=1992;citation_issue=7;citation_issn=0022-3050;citation_pmid=1386382;citation_doi=10.1136/jnnp.55.7.553" />
<meta name="citation_reference" content="citation_journal_title=Neuroradiology;citation_journal_abbrev=Neuroradiology;citation_author=G. Bavinzski;citation_author=M. Killer;citation_author=A. Gruber;citation_title=Treatment of post-traumatic carotico-cavernous fistulae using electrolytically detachable coils: technical aspects and preliminary experience.;citation_pages=81-85;citation_volume=39;citation_year=1997;citation_issue=2;citation_pmid=9045966;citation_doi=10.1007/s002340050371" />
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<meta name="twitter:title" content="Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Cranial nerve palsies are regularly observed in patients with arteriovenous fistulas of the cavernous sinus. The purpose of our study was to determine the long-term clinical outcome—with a special focus on extra-ocular muscular dysfunctions—in patients who had undergone endovascular treatment of a cavernous sinus fistula with detachable coils.

MATERIALS AND METHODS: Sixteen patients were recalled for an ophthalmoneurologic control examination (mean interval of 4.4 years). The mRS and the EQ-5D questionnaire were used for the description of general outcome. Age, duration of symptoms, character of the fistula (direct, dural), and coil volume were tested to assess their relevance for persistent symptoms.

RESULTS: All patients displayed complete regression of chemosis, exophthalmus, and pulsating tinnitus with no evidence of recurrences. Oculomotor disturbances persisted in 9 of 13 patients and caused permanent diplopia in 7 patients. In 15 patients a mRS score of 1 or 2 was achieved; however, 7 patients reported some limitations in life quality (EQ-5D). A significant correlation was found between coil volume and persistent diplopia ( P = .032) and persistent cranial nerve VI paresis ( P = .037).

CONCLUSIONS: Coil embolization of the cavernous sinus led to durable closure of AVF and reliable regression of acute symptoms. However, long-term follow-up showed a 44% rate of persistent cranial nerve deficits with disturbances of oculomotor and visual functions. This may be explained by the underlying fistula size itself and/or the space-occupying effect of the coils. As neuro-ophthalmologic outcome is crucial for control of therapeutic success, patients should be routinely examined by ophthalmologists.

AVF
:   arteriovenous fistula
CNP
:   cranial nerve palsies
CS
:   cavernous sinus
ICA
:   internal carotid artery
LR
:   likelihood ratio
mRS
:   modified Rankin Scale
na
:   not available
SOV
:   superior ophthalmic vein" />
<meta name="og-title" property="og:title" content="Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/7/1216" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Cranial nerve palsies are regularly observed in patients with arteriovenous fistulas of the cavernous sinus. The purpose of our study was to determine the long-term clinical outcome—with a special focus on extra-ocular muscular dysfunctions—in patients who had undergone endovascular treatment of a cavernous sinus fistula with detachable coils.

MATERIALS AND METHODS: Sixteen patients were recalled for an ophthalmoneurologic control examination (mean interval of 4.4 years). The mRS and the EQ-5D questionnaire were used for the description of general outcome. Age, duration of symptoms, character of the fistula (direct, dural), and coil volume were tested to assess their relevance for persistent symptoms.

RESULTS: All patients displayed complete regression of chemosis, exophthalmus, and pulsating tinnitus with no evidence of recurrences. Oculomotor disturbances persisted in 9 of 13 patients and caused permanent diplopia in 7 patients. In 15 patients a mRS score of 1 or 2 was achieved; however, 7 patients reported some limitations in life quality (EQ-5D). A significant correlation was found between coil volume and persistent diplopia ( P = .032) and persistent cranial nerve VI paresis ( P = .037).

CONCLUSIONS: Coil embolization of the cavernous sinus led to durable closure of AVF and reliable regression of acute symptoms. However, long-term follow-up showed a 44% rate of persistent cranial nerve deficits with disturbances of oculomotor and visual functions. This may be explained by the underlying fistula size itself and/or the space-occupying effect of the coils. As neuro-ophthalmologic outcome is crucial for control of therapeutic success, patients should be routinely examined by ophthalmologists.

AVF
:   arteriovenous fistula
CNP
:   cranial nerve palsies
CS
:   cavernous sinus
ICA
:   internal carotid artery
LR
:   likelihood ratio
mRS
:   modified Rankin Scale
na
:   not available
SOV
:   superior ophthalmic vein" />
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      <h1 class="highwire-cite-title" id="page-title">Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">A. Bink</span>, <span class="highwire-citation-author" data-delta="1">K. Goller</span>, <span class="highwire-citation-author" data-delta="2">M. Lüchtenberg</span>, <span class="highwire-citation-author" data-delta="3">T. Neumann-Haefelin</span>, <span class="highwire-citation-author" data-delta="4">S. Dützmann</span>, <span class="highwire-citation-author" data-delta="5">F. Zanella</span>, <span class="highwire-citation-author" data-delta="6">J. Berkefeld</span> and <span class="highwire-citation-author" data-delta="7">R. du Mesnil de Rochemont</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1216-1221; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2040 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9764--61449962857" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">A. Bink </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BBink%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Bink%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.%2BBink%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">K. 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<p id="p-1"><strong>BACKGROUND AND PURPOSE: </strong>Cranial nerve palsies are regularly observed in patients with arteriovenous fistulas of the cavernous sinus. The purpose of our study was to determine the long-term clinical outcome—with a special focus on extra-ocular muscular dysfunctions—in patients who had undergone endovascular treatment of a cavernous sinus fistula with detachable coils.</p>
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<p id="p-2"><strong>MATERIALS AND METHODS: </strong>Sixteen patients were recalled for an ophthalmoneurologic control examination (mean interval of 4.4 years). The mRS and the EQ-5D questionnaire were used for the description of general outcome. Age, duration of symptoms, character of the fistula (direct, dural), and coil volume were tested to assess their relevance for persistent symptoms.</p>
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<p id="p-3"><strong>RESULTS: </strong>All patients displayed complete regression of chemosis, exophthalmus, and pulsating tinnitus with no evidence of recurrences. Oculomotor disturbances persisted in 9 of 13 patients and caused permanent diplopia in 7 patients. In 15 patients a mRS score of 1 or 2 was achieved; however, 7 patients reported some limitations in life quality (EQ-5D). A significant correlation was found between coil volume and persistent diplopia (<em>P</em> = .032) and persistent cranial nerve VI paresis (<em>P</em> = .037).</p>
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<p id="p-4"><strong>CONCLUSIONS: </strong>Coil embolization of the cavernous sinus led to durable closure of AVF and reliable regression of acute symptoms. However, long-term follow-up showed a 44% rate of persistent cranial nerve deficits with disturbances of oculomotor and visual functions. This may be explained by the underlying fistula size itself and/or the space-occupying effect of the coils. As neuro-ophthalmologic outcome is crucial for control of therapeutic success, patients should be routinely examined by ophthalmologists.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AVF<span class="def-item-dt-sep"></span></dt><dd>arteriovenous fistula<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">CNP<span class="def-item-dt-sep"></span></dt><dd>cranial nerve palsies<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">CS<span class="def-item-dt-sep"></span></dt><dd>cavernous sinus<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">ICA<span class="def-item-dt-sep"></span></dt><dd>internal carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">LR<span class="def-item-dt-sep"></span></dt><dd>likelihood ratio<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">mRS<span class="def-item-dt-sep"></span></dt><dd>modified Rankin Scale<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">na<span class="def-item-dt-sep"></span></dt><dd>not available<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">SOV<span class="def-item-dt-sep"></span></dt><dd>superior ophthalmic vein</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/7/1216.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1216-1221; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2040 </span></div>
  
  
  
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      <div class="highwire-cite-title">Long-Term Outcome after Coil Embolization of Cavernous Sinus Arteriovenous Fistulas</div>  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Aug 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1216-1221; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2040 </span></div>
  
  
  
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