{
  "abstract": "Background Cavernous sinus dural arteriovenous fistulas (CS-DAVFs) present significant treatment challenges when the inferior petrosal sinus (IPS) is not opacified during cerebral angiography. The consistently visible superior ophthalmic vein (SOV) offers a promising alternative, though it has yet to be fully evaluated in large-scale studies.Methods This retrospective, case–control study was conducted between May 2017 and October 2024. Data collection for this multicenter, population-based study took place across eight tertiary referral centers. Eligible patients diagnosed with CS-DAVF and non-visualized IPS were treated either via the transvenous SOV approach or the IPS recanalization approach.Results Of 178 eligible cases, 70 cases (39.33%) were treated using the transvenous SOV approach, while 108 cases (60.67%) underwent the transvenous IPS approach. The initial treatment success rate was significantly higher in the SOV group compared with the IPS group (91.43% vs 75.93%; OR 3.38, 95% CI 1.30 to 8.35, P=0.01). The overall complication rate was 1.43% in the SOV group and 2.78% in the IPS group (OR 0.51, 95% CI 0.04 to 3.47, P>0.99). After classifying the SOV approach into simple and complex types, the SOV-simple type further demonstrated significant advantages, including shorter average operation times (126.20±46.99 min, P=0.02) and a higher initial treatment success rate (95.65%, P=0.003) compared with the IPS group.Conclusion The SOV approach is recommended as a first-line treatment for CS-DAVF patients with ‘invisible’ IPS.",
  "authors": [
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Jingwei Zheng"
    },
    {
      "affiliations": [
        "Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China"
      ],
      "name": "Shixing Su"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Jiangsu Province People’s Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China"
      ],
      "name": "Hua Lu"
    },
    {
      "affiliations": [
        "Department of Interventional Radiology, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, JiangSu, China"
      ],
      "name": "Sheng Liu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China"
      ],
      "name": "Shengjun Zhou"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China"
      ],
      "name": "Qi Jia"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Jinhua Municipal Central Hospital, Jinhua, Zhejiang, China"
      ],
      "name": "Xiang Bao"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Ningbo Medical Centre Lihuili Hospital, Ningbo, Zhejiang, China"
      ],
      "name": "Zhenqiang Li"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, China"
      ],
      "name": "Haihang Zhou"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Guoqiang Zhang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Zhijie Jiang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Fei Liu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, Affiliated Huzhou FuYin Hospital of Huzhou University, Huzhou, China"
      ],
      "name": "Si Hu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Zixin Wang"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Jun Yu"
    },
    {
      "affiliations": [
        "Department of Neurosurgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China",
        "Clinical Research Center for Neurological Diseases of Zhejiang Province, Hangzhou, Zhejiang, China",
        "State Key Laboratory of Transvascular Implantation Devices, Hangzhou, Zhejiang, China"
      ],
      "name": "Liang Xu"
    }
  ],
  "title": "Comparison of superior ophthalmic vein approach and inferior petrosal sinus recanalization in the treatment of cavernous sinus dural arteriovenous fistula: a multicenter retrospective study",
  "uid": "e435fe01-fd2e-582b-b598-9a457bcfe734"
}