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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations

Published on: October 20, 2017

Middle temporal vein approach for transvenous embolization of cavernous sinus dural arteriovenous fistula: A case

Masaomi Takeuchi¹, Yoichi Morofuji^1,2, Eri Shiozaki¹

¹Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Surgical Neurology International

|October 20, 2025

Abstract

Background:

Transvenous embolization (TVE) is the preferred treatment for cavernous sinus (CS) dural arteriovenous fistula (dAVF), typically accessed through the inferior petrosal sinus (IPS). In cases where the IPS is inaccessible, alternative routes are required.

Case Description:

We report a case of an 87-year-old female with left conjunctival hyperemia and exophthalmos due to the left CS dAVF draining into the superior ophthalmic vein. Because of the IPS occlusion and severe facial vein tortuosity and stenosis, TVE was performed through the middle temporal vein (MTV).

Conclusion:

This case demonstrates the feasibility and effectiveness of the MTV route for TVE in anatomically challenging CS dAVF cases.

Keywords:

Cavernous sinus dural arteriovenous fistula Middle temporal vein Transvenous embolization

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