A Case of Cavernous Sinus Dural Arteriovenous Fistula with Persistent Left Superior Vena Cava

• DOI: 10.5797/jnet.cr.2024-0047
• Publication Date: 2025-01-27T22:12:11Z
• Authors: Hikaru Nakamura; Yoichi Morofuji; Kazuaki Okamura; Takeshi Hiu; Takayuki Matsuo

Persistent left superior vena cava (PLSVC) is rare, occurring in approximately 0.3%-0.5% of the population. In endovascular treatment (EVT), internal jugular vein (IJV) approached via innominate from cava; however, occasionally absent patients with PLSVC. Careful consideration required when performing EVT, particularly transvenous embolization (TVE). A 70-year-old female presented a cavernous sinus dural arteriovenous fistula. Left external carotid angiography findings showed that multiple feeders ascending pharyngeal artery, accessory meningeal middle and artery foramen rotundum had formed shunted pouch posterolateral to sinus. We initially planned perform TVE right femoral vein. However, PLSVC was detected on common angiography. Consequently, IJV coil were performed, resulting disappearance shunt. The patient discharged without neurological deficits. rarely observed thoracic venous malformation, few reports concerning its management cerebrovascular EVT. Contrast-enhanced computed tomography useful for diagnosis; most are clinically asymptomatic this abnormality typically an incidental finding, remaining challenging detect during preoperative examination. It essential consider possibility verify appropriate access route, including atrial level phase, cerebral