Lessons Learned from Difficult or Unsuccessful Cannulations of the Superior Ophthalmic Vein in the Treatment of Cavernous Sinus Dural Fistulas

Although the SOV is a useful route for CDF embolization, the presence of fragile or clotted veins can preclude successful cannulation. Deeper orbital dissections carry a higher risk of uncontrolled bleeding and should be avoided, especially in older patients with fragile veins and those with recently diagnosed high-flow fistulas.