Endoscopic-assisted Orbitotomy for Obliteration of Orbital Arteriovenous Fistula Refractory to Endovascular Techniques
Hossein Ghahvehchian1 , Nasser Karimi1 *, Mohsen Bahmani Kashkouli1 , Mohammad Ramadan1 , Kiandokht Ghamari1 , SeyyedSaeed Aghili1
- Ophthalmology Department, Eye Research Center, The Five Senses Health Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
Abstract: This report presents a spontaneous orbital arteriovenous fistula in a patient with lymphaticvenous malformation treated with direct endoscopic-assisted ablation after two failed trials of endovascular intervention.
Methods: Case report
Results: Spontaneous orbital arteriovenous fistula (AVF) is a rare acquired disorder. The coincidence of AVF with lymphaticvenous malformation (LVM) is even rarer. AVFs often develop spontaneously or are secondary to trauma. Surgical approaches vary widely, with associated pros and cons. The purpose of this case report is to describe an orbital AVF in a 25-year-old man with congenital fronto-orbital LVM, refractory to endovascular micro catheterization and glue embolization, which was later successfully ablated through direct endoscopic-assisted orbital approach.
Conclusion: spontaneous onset orbital AVF may coincide with fronto-orbital and periocular LVM, as reported here, which seems extremely rare. Direct surgical ablation of the fistula, assisted by endoscopic techniques, is a viable option for fistula closure without significant risk of iatrogenic injury.
