Treatment of a Giant Orbitofacial Vascular Malformation and Ophthalmic Artery Aneurysms with Intralesion Glue Injections: Case Report

Pre-embolization photograph of left orbitonasal region shows large, disfiguring orbital vascular malformation.

fig 2. Lateral view angiogram of the left external carotid artery shows large dilated anterior branches of the external carotid artery, some blush, and early venous drainage.

fig 3. Lateral view angiogram of the left internal carotid artery injection reveals that a large dilated ophthalmic artery feeds the vascular malformation and two intradural aneurysms at its origin (arrows).

fig 4. Lateral view angiogram of the left internal carotid artery, obtained after embolization, shows that the left ophthalmic artery and two saccular aneurysms are no longer visible. During embolization, we fluoroscopically observed retrograde reflux of embolic material into the distal ophthalmic artery, so it is not visible in this figure. Some reflux of contrast material into the anterior branches of the external carotid artery is seen.

fig 5. Lateral view angiogram of the left external carotid artery, obtained after percutaneous embolization, shows residual malformation (arrows).

fig 6. After additional transarterial embolization, angiogram of the external carotid artery shows complete occlusion of the vascular malformation.

fig 7. Postoperative photograph obtained 1 week after surgery. Early postoperative edema is seen in the orbitonasal region.

fig 8. Postoperative photograph obtained 3 months after surgery. Complete resolution of the edema is seen