Key result
Dual-microcatheter coil embolization with Onyx-18 and DAPT resolves coexisting cavernous fistula and vertebral aneurysm.
Case Report (n=1)
Endovascular embolization for a cavernous sinus fistula combined with conservative dual antiplatelet therapy for a coexisting vertebral artery dissecting aneurysm resulted in complete resolution of the aneurysm at 11 months.
A 41-years-old woman presented with left-sided headache, diplopia, and ptosis of the left eyelid. Cerebral computed tomography angiography revealed a left persistent primitive trigeminal artery cavernous sinus fistula and a dissecting aneurysm in the V4 segment of the left vertebral artery. Digital subtraction angiography confirmed the diagnosis. The fistula was successfully occluded using dual-microcatheter coil embolization combined with Onyx-18 injection, assisted by balloon protection of the internal carotid artery. The vertebral artery dissecting aneurysm was managed conservatively by administering dual antiplatelet therapy (aspirin (100 mg/day) and clopidogrel (75 mg/day) for 3 months). Follow-up imaging at 11 months demonstrated complete resolution of the aneurysm.
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Wen et al. (2026) conducted a case report in Persistent primitive trigeminal artery cavernous sinus fistula coexisting with left vertebral artery dissecting aneurysm (n=1). Dual-microcatheter coil embolization combined with Onyx-18 injection and dual antiplatelet therapy was evaluated on Resolution of fistula and aneurysm. Dual-microcatheter coil embolization with Onyx-18 and conservative management with dual antiplatelet therapy successfully treated a coexisting cavernous sinus fistula and vertebral artery aneurysm.
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