We present an alternative endovascular approach to treat dural anterio-venous fistulas (AVFs) of the cavernous sinus that drain only into the superior ophthalmic vein. Two cases of dural AVFs of the cavernous sinus producing increased intraocular pressure and diminishing visual acuity are reported. The cavernous sinus was accessed via the direct superficial temporal vein approach through the superior ophthalmic vein. Successful embolization was documented radiographically and clinically.
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