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Clinical case of multiple metachronous intraorbital arteriovenous fistulas in a patient with congenital heart disease

https://doi.org/10.17650/1683-3295-2024-26-4-81-87

Abstract

   Intraorbital arteriovenous fistulas are rare arteriovenous shunts inside the orbit without connection with the cavernous sinus. This article describes a clinical case of multiple metachronous intraorbital arteriovenous shunts in a patient with univentricular heart disease and secondary erythrocytosis. Transarterial embolization of the first shunt had a positive clinical effect for 2 months. The recurrence of symptoms was caused by the formation of a new shunt on the same draining vein, but in a place remote from the previous locus. Repeated embolization gave a positive effect for the same period. The next relapse had a more malignant course, up to dislocation of the eyeball. The right orbit decompression has given a stable positive clinical effect up to the present moment. Based on extremely limited literature data of such cases and our own experience, we concluded that an individual and multidisciplinary approach to such patients with careful postoperative follow-up is necessary.

About the Authors

A. A. Glushaeva
E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

Alexandra Andreevna Glushaeva

630055; 15 Rechkunovskaya St.; Novosibirsk



D. S. Kislitsin
E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

630055; 15 Rechkunovskaya St.; Novosibirsk



T. S. Shayakhmetov
E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

630055; 15 Rechkunovskaya St.; Novosibirsk



M. G. Kilchukov
E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

630055; 15 Rechkunovskaya St.; Novosibirsk



R. S. Kiselyov
E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

630055; 15 Rechkunovskaya St.; Novosibirsk



A. V. Gorbatykh
E. N. Meshalkin National Medical Research Center, Ministry of Health of Russia
Russian Federation

630055; 15 Rechkunovskaya St.; Novosibirsk



References

1. Kim A.W., Kosmorsky G.S. Arteriovenous communication in the orbit. J Neuroophthalmol 2000;20(1):17–9. DOI: 10.1097/00041327-200020010-00006

2. Kirsch M., Henkes H. A ruptured intraorbital ophthalmic artery aneurysm, associated with a dural arteriovenous fistula: сombined transarterial and transvenous endovascular treatment. Minim Invasive Neurosurg 2011;54(3):128–31. DOI: 10.1055/s-0031-1277230

3. Williamson R.W., Ducruet A.F., Crowley R.W. et al. Transvenous coil embolization of an intraorbital arteriovenous fistula : сase report and review of the literature. Neurosurgery 2013;72(1):E130–4; discussion E134. DOI: 10.1227/NEU.0b013e31827242cb

4. Hamada J., Morioka M., Kai Y. et al. Spontaneous arteriovenous fistula of the orbit: case report. Surg Neurol 2006;65(1):55–7; discussion 57. DOI: 10.1016/j.surneu.2005.03.043

5. Lin C.J., Blanc R., Clarençon F. et al. Transvenous embolization of an intraorbital arteriovenous fistula using Onyx. J Clin Neurosci 2010;17(6):783–5. DOI: 10.1016/j.jocn.2009.09.035

6. Caragine L.P. Jr., Halbach V.V., Dowd C.F. et al. Intraorbital arteriovenous fistulae of the ophthalmic veins treated by transvenous endovascular occlusion: technical case report. Neurosurgery 2006;58(1 Suppl):ONS–E170; discussion ONS–E170. DOI: 10.1227/01.NEU.0000193526.48167.F7

7. Naqvi J., Laitt R., Leatherbarrow B. et al. A case of a spontaneous intraorbital arteriovenous fistula: сlinicoradiological findings and treatment by transvenous embolisation via the superior ophthalmic vein. Orbit 2013;32(2):124–6. DOI: 10.3109/01676830.2013.764444

8. Lv X., Li W., Liu A. et al. Endovascular treatment evolution for pure intraorbital arteriovenous fistula : three case reports and literature review. Neuroradiol J 2017;30(2):151–9. DOI: 10.1177/1971400917692163

9. Gao P., Zhu Y., Ling F. et al. Nonischemic cerebral venous hypertension promotes a pro-angiogenic stage through HIF-1 downstream genes and leukocyte-derived MMP-9. J Cereb Blood Flow Metab 2009;29(8):1482–90. DOI: 10.1038/jcbfm.2009.67

10. Hacein-Bey L., Konstas A.A., Pile-Spellman J. Natural history, current concepts, classification, factors impacting endovascular therapy, and pathophysiology of cerebral and spinal dural arteriovenous fistulas. Clin Neurol Neurosurg 2014;121:64–75. DOI: 10.1016/j.clineuro.2014.01.018

11. Terada T., Tsuura M., Komai N. et al. The role of angiogenic factor bFGF in the development of dural AVFs. Acta Neurochir (Wien) 1996;138(7):877–83. DOI: 10.1007/BF01411267

12. Barnwell S.L., Halbach V.V., Dowd C.F. et al. Multiple dural arteriovenous fistulas of the cranium and spine. AJNR Am J Neuroradiol 1991;12(3):441–5.

13. Ha S.Y., Kwon Y.S., Kim B.M. et al. Clinical and angiographic characteristics of multiple dural arteriovenous shunts. AJNR Am J Neuroradiol 2012;33(9):1691–5. DOI: 10.3174/ajnr.A3054

14. Van Dijk J.M., TerBrugge K.G., Willinsky R.A., Wallace M.C. Multiplicity of dural arteriovenous fistulas. J Neurosurg 2002;96(1):76–8. DOI: 10.3171/jns.2002.96.1.0076

15. Pepin M., Schwarze U., Superti-Furga A., Byers P.H. Clinical and genetic features of Ehlers–Danlos syndrome type IV, the vascular type. N Engl J Med 2000;342(10):673–80. DOI: 10.1056/NEJM200003093421001

16. Desal H.A., Toulgoat F., Raoul S. et al. Ehlers–Danlos syndrome type IV and recurrent carotid-cavernous fistula : review of the literature, endovascular approach, technique and difficulties. Neuroradiology 2005;47(4):300–4. DOI: 10.1007/s00234-005-1378-4


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For citations:


Glushaeva A.A., Kislitsin D.S., Shayakhmetov T.S., Kilchukov M.G., Kiselyov R.S., Gorbatykh A.V. Clinical case of multiple metachronous intraorbital arteriovenous fistulas in a patient with congenital heart disease. Russian journal of neurosurgery. 2024;26(4):81-87. (In Russ.) https://doi.org/10.17650/1683-3295-2024-26-4-81-87

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ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)
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