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Endovascular treatment evolution for pure intraorbital arteriovenous fistula: Three case reports and literature review.

Abstract Background and importance Intraorbital arteriovenous fistulas (IOAVFs) are rare and cause eye redness, exophthalmos, blurry vision and bruit. Whereas in the past they were treated conservatively, surgically or transarterially, recent developments in transvenous embolization have improved their treatment. In this paper the authors report three cases of IOAVFs treated endovascularly and review the evolution of treatment options. Methods Three cases of purely IOAVF enrolled in our center were reported and a PubMed literature search was performed using "pure intraorbital arteriovenous fistula" and "arteriovenous fistula of the optic nerve sheath." A total of 21 papers were reviewed in full, focusing primarily on the treatment and outcomes. Results A total of 26 patients were obtained, including our three patients and 23 patients reported in the literature. In nine patients treated conservatively, four spontaneous occlusions, one visual deterioration and four cases with unknown outcome were reported. In another 18 patients, 29 therapies (including five surgical treatment, 11 transarterial embolizations and 13 transvenous embolizations) were attempted and resulted in 12 cures, five visual deteriorations and one without reported outcome. More recently, transvenous embolization has become the mainstay of IOAVF treatment. Of the 21 patients assessed between 2000 and 2013, a transvenous approach was attempted in 13 patients; nine patients were cured without any adverse events. Conclusion Development and improvement of transvenous techniques are found to be safe and effective for patients with IOAVF.
PMID
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Authors

Mayor MeshTerms
Keywords

Treatment

arteriovenous fistula

endovascular

evolution

intraorbital

pure

Journal Title the neuroradiology journal
Publication Year Start




PMID- 28424011
OWN - NLM
STAT- MEDLINE
DA  - 20170420
DCOM- 20170501
LR  - 20170501
IS  - 2385-1996 (Electronic)
IS  - 1971-4009 (Linking)
VI  - 30
IP  - 2
DP  - 2017 Apr
TI  - Endovascular treatment evolution for pure intraorbital arteriovenous fistula:
      Three case reports and literature review.
PG  - 151-159
LID - 10.1177/1971400917692163 [doi]
AB  - Background and importance Intraorbital arteriovenous fistulas (IOAVFs) are rare
      and cause eye redness, exophthalmos, blurry vision and bruit. Whereas in the past
      they were treated conservatively, surgically or transarterially, recent
      developments in transvenous embolization have improved their treatment. In this
      paper the authors report three cases of IOAVFs treated endovascularly and review 
      the evolution of treatment options. Methods Three cases of purely IOAVF enrolled 
      in our center were reported and a PubMed literature search was performed using
      "pure intraorbital arteriovenous fistula" and "arteriovenous fistula of the optic
      nerve sheath." A total of 21 papers were reviewed in full, focusing primarily on 
      the treatment and outcomes. Results A total of 26 patients were obtained,
      including our three patients and 23 patients reported in the literature. In nine 
      patients treated conservatively, four spontaneous occlusions, one visual
      deterioration and four cases with unknown outcome were reported. In another 18
      patients, 29 therapies (including five surgical treatment, 11 transarterial
      embolizations and 13 transvenous embolizations) were attempted and resulted in 12
      cures, five visual deteriorations and one without reported outcome. More
      recently, transvenous embolization has become the mainstay of IOAVF treatment. Of
      the 21 patients assessed between 2000 and 2013, a transvenous approach was
      attempted in 13 patients; nine patients were cured without any adverse events.
      Conclusion Development and improvement of transvenous techniques are found to be 
      safe and effective for patients with IOAVF.
FAU - Lv, Xianli
AU  - Lv X
AD  - Interventional Neuroradiology Department, Beijing Neurosurgical Institute and
      Beijing Tiantan Hospital, Capital Medical University, China.
FAU - Li, Wei
AU  - Li W
AD  - Interventional Neuroradiology Department, Beijing Neurosurgical Institute and
      Beijing Tiantan Hospital, Capital Medical University, China.
FAU - Liu, Aihua
AU  - Liu A
AD  - Interventional Neuroradiology Department, Beijing Neurosurgical Institute and
      Beijing Tiantan Hospital, Capital Medical University, China.
FAU - Lv, Ming
AU  - Lv M
AD  - Interventional Neuroradiology Department, Beijing Neurosurgical Institute and
      Beijing Tiantan Hospital, Capital Medical University, China.
FAU - Jiang, Chuhan
AU  - Jiang C
AD  - Interventional Neuroradiology Department, Beijing Neurosurgical Institute and
      Beijing Tiantan Hospital, Capital Medical University, China.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20170313
PL  - United States
TA  - Neuroradiol J
JT  - The neuroradiology journal
JID - 101295103
SB  - IM
MH  - Aged
MH  - Arteriovenous Fistula/diagnostic imaging/*surgery
MH  - Cerebral Angiography
MH  - Embolization, Therapeutic/*methods
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
OTO - NOTNLM
OT  - *Treatment
OT  - *arteriovenous fistula
OT  - *endovascular
OT  - *evolution
OT  - *intraorbital
OT  - *pure
EDAT- 2017/04/21 06:00
MHDA- 2017/05/02 06:00
CRDT- 2017/04/21 06:00
AID - 10.1177/1971400917692163 [doi]
PST - ppublish
SO  - Neuroradiol J. 2017 Apr;30(2):151-159. doi: 10.1177/1971400917692163. Epub 2017
      Mar 13.

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