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June 1996

Techniques and Surgical Approach for Transvenous Embolization

Author Affiliations

New York, NY

Arch Ophthalmol. 1996;114(6):750. doi:10.1001/archopht.1996.01100130742021

Goldberg et al1 have clearly described the techniques and surgical approach for transvenous embolization via the ophthalmic artery route in the treatment of dural arteriovenous shunts that involve the cavernous sinus. Their article concerns an approach for therapy and not necessarily the indications for treatment, as this has been handled in previous publications.2 Progressive ophthalmoplegia, progressive proptosis with exposure, uncontrolled elevation of intraocular pressure, retinopathy or optic neuropathy, and abnormal cortical venous drainage noted on magnetic resonance imaging are all indications for treating this disorder. The older literature, all written prior to the development of newer angiographic catheters that allow selective catheterization of the involved abnormal vessels and the development of new materials for embolization such as platinum coils or inflatable detachable balloons, had stated that follow-up for these patients should be conservative. Of course, this is because of the previous high risk for complications from intra-arterial or

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