Analysis of the Effect of Superselective Ophthalmic Artery Thrombolysis for Central Retinal Artery Occlusion.

INTRODUCTION: The aim of the study was to investigate the clinical efficacy of superselective ophthalmic artery thrombolysis for central retinal artery occlusion (CRAO). METHODS: Retrospective study of CRAO patients who attended the Department of Ophthalmology of Affiliated Hospital of Weifang Medical University from January 2022 to July 2023, 138 CRAO patients with onset time of 1-3 days were selected for the study. Among them, 86 patients refused thrombolytic treatment and chose to adopt traditional treatment, which was categorized as the control group; 52 patients adopted superselective ophthalmic artery thrombolytic treatment, which was categorized as the observation group. The visual acuity of the patients treated with traditional modality on the 4th day after the onset of the disease and the visual acuity of the patients treated with superselective ophthalmic artery thrombolysis on the 1st postoperative day were recorded, and the visual acuity improvement after different modalities of treatment was compared between the two groups. RESULTS: In the control group, 77 (89.5%) of the treated patients had no improvement in visual acuity, 9 (10.5%) had improvement, 0 (0.0%) had significant improvement, and the total improvement was 9 (10.5%); in the observation group, 18 (34.6%) of the treated patients had no improvement in visual acuity, 21 (40.4%) had improvement, 13 (25.0%) had significant improvement, and the total improvement was 34 (65.4%). The total improvement rate of treatment in the observation group was 65.4%, which was significantly higher than the 10.5% in the control group, and the difference was statistically significant (p < 0.05). CONCLUSION: Superselective ophthalmic artery thrombolysis for patients with CRAO is clinically effective, promotes improvement in patient vision, and has a high safety profile.

Transverse-Sigmoid Sinus Dural Arteriovenous Fistula Concurrent With Bilateral Venous Sinus Occlusion.

BACKGROUND AND SIGNIFICANCE: Dural arteriovenous fistula (DAVF) is a relatively rare type of cerebrovascular malformation with unknown pathogenesis. Here, the authors report a patient with DAVF in the left transverse-sigmoid sinus (Cognard type III) combined with occlusions of the left sigmoid sinus and right transverse sinus. The authors describe and discuss their successful treatment approach, with the aim to improve the management of this rare disorder. CASE PRESENTATION: A 59-year-old man presented with dizziness, headache, vomiting, and unsteady gait. His digital subtraction angiography evaluation indicated DAVF in the left transverse-sigmoid sinus (Cognard type III) combined with occlusions of the distal 1/3 of the left sigmoid sinus and the proximal one-third of the right transverse sinus. After balloon angioplasty and stenting, blood flow was restored in the occluded sinuses. The DAVF was treated by embolization. The patient had a satisfactory recovery with significantly improved clinical symptoms. CONCLUSION: In patients with transverse-sigmoid sinus DAVF, satisfactory venous reflux should be ensured. In patients with concurrent DAVF and sinus stenosis or occlusion, it is important to reestablish antegrade venous blood flow first. It is feasible and safe to simultaneously embolize DAVF after the venous reflux can be reestablished.