Direct Orbital Puncture of the Cavernous Sinus for the Treatment of a Carotid-Cavernous Dural AV Fistula with a Concomitant Venous/Lymphatic Malformation

Abstract

A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.

• Carotid-cavernous fistula
• lateral orbitotomy
• orbital venous/lympathic malformation
• proptosis
• transorbital puncture