PMC5234300_01
Contrast-enhanced T1-weighted magnetic resonance imaging in coronal view showing a nonfunctioning pituitary adenoma. The tumor size was 2.5 x 2 x 2 cm, with suprasellar extension and compression of the optic chiasm
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F1
A previously healthy 46-year-old man was referred to our clinic because of visual symptoms and a nonfunctional pituitary adenoma with suprasellar growth that compressed the optic chiasm [Figure 1].
Digital subtraction angiography of the right common carotid artery in lateral view: (a) image in arterial phase showing a lesion in the sphenopalatine artery (arrow); (b) a later image showing arteriovenous shunt with venous filling (arrow) and extravasation of contrast agent (black arrow)
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F2
Digital subtraction angiography (DSA) of the right common carotid artery revealed irregularities in the wall of the right sphenopalatine artery and an arteriovenous shunt to a vein directed toward the internal jugular vein, with contrast agent extravasation at the fistula point [Figure 2].
Digital subtraction angiography after microcatheterization of the right sphenopalatine artery showing the arteriovenous fistula before embolization: (a) Anterior posterior view; (b) lateral view
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F3
A microcatheter was navigated into the sphenopalatine artery [Figure 3], and embolization of the arteriovenous fistula was done using 0.5 ml glue (N-butyl-2-cyanoacrylate and Lipiodol in proportion 1:2).
Digital subtraction angiography of the right common carotid artery in anterior posterior view: The arteriovenous fistula is occluded and the posterior septal branch of the sphenopalatine artery (arrow) is occluded
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F4
Angiography of the right common carotid artery did not show any remaining arteriovenous shunt or contrast agent extravasation; the posterior septal branch of the sphenopalatine artery was occluded [Figure 4], indicating this branch as the lesion site.