Direct Puncture Preoperative Embolization for Cavernous Venous Malformation of the Orbit - Abstract
Orbital cavernous venous malformation -previously called hemangioma-, is a common adult orbital space occupying lesion. Large symptomatic lesions may warrant surgical removal. Intraoperative bleeding however may extend the intraoperative time and prevent complete excision. Pre-operatory embolization of the external carotid artery supply may be of help. However, some lesions have significant ophthalmic artery supply. In this particular scenario, surgical exposure of the lesion and direct puncture followed by liquid embolic injection have been described. We report a case of fluoroscopic guided direct puncture of the malformation and almost complete obliteration with n-butyl cyanoacrylate. Direct puncture embolization allowed a rapid surgical removal of the malformation with minimal blood loss.