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Updated: Jan 14, 2026
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Transvenous targeted embolization of cavernous sinus dural arteriovenous fistula: A single center experience
Che Jiang1, Yuhang Zhang1, Guoli Duan2
1Department of Neurovascular Center, Changhai Hospital Affiliated to the Naval Medical University, Changhai Road 168, Shanghai 200433, China; Department of Neurosurgery, General Hospital of Southern Theater Command, 111 Liuhua Road, Guangzhou, Guangdong 510010, China.
Background:
This study aimed to summarize features of cavernous sinus dural arteriovenous fistula (CSDAVF) in a Chinese population and investigate the therapeutic efficacy and procedural safety of transvenous targeted embolization versus conventional non-targeted approaches.
Methods:
Between October 2000 and October 2022, 92 consecutive patients with CSDAVFs undergoing endovascular transvenous embolization at our tertiary neurovascular center were retrospectively reviewed. Targeted embolization (TE) was defined as selective obliteration of the arteriovenous shunt and immediate adjacent cavernous sinus compartments, while non-targeted embolization (NTE) involved occlusion of the entire cavernous sinus lumen. Procedural parameters, angiographic outcomes, clinical symptom resolution (particularly cranial neuropathies [CNP]), and complication profiles were systematically compared between groups.
Results:
The cohort demonstrated an 89.1 % overall technical success rate (82/92) with transvenous embolization. TE procedures (n = 21) required significantly lower embolic agent volumes compared to NTE. While immediate complete occlusion rates showed no intergroup difference, the TE group exhibited superior CNP resolution at discharge and sustained improvement at follow-up. Angiographic outcomes remained comparable across groups. According to the classification proposed by Suh, CSDAVF of the late restrictive type or the restrictive type was more suitable for targeted embolization.
Conclusion:
The strategy of targeted embolization, through precise identification and blockade of the shunt point and immediate adjacent CS compartments, can reduce the use of embolic materials and tend to lower the risk of complications, while maintaining a high rate of complete occlusion.
