Treatment Of Carotid-cavernous Sinus Fistula Research Articles

Transradial access embolization of carotid-cavernous fistulae: Case report.

Carotid-Cavernous sinus fistula (CCF) represents a misdiagnosed condition with potential repercussion in functional, neurological, and social roles of patients with this disease. Earlier reports remark on the efficiency and safety of endovascular therapy with resolution of the symptoms were performed appropriately. We present a case of a male patient from a developing country, with gunshot wound head trauma history and short-term progressive functional and neurological impairment in the presence of intracranial hypertension and ocular symptoms who developed a large CFF, subsequently treated by transradial access embolization. We aim to describe the real-world experience in diagnosis and treatment of CCFs, emphasizing on the scope and outcomes of the endovascular treatment. This case supports worldwide experience, positioning endovascular therapy as an effective strategy in the resolution of CFFs, and the relevance of suspecting this disease in the presence of typical symptoms, even if they are rapidly progressive.

E-033 Treatment of Carotid-Cavernous Fistulas with a Double Lumen Balloon

IntroductionTreatment of direct high-flow carotid-cavernous sinus fistulas (CCF) can be challenging. Treatment of CCFs with dual lumen balloons has not been described.PurposeTo describe two cases in which the CCF was...

Combined coil embolism and stent graft implantation in the treatment of carotid-cavernous sinus fistula associated with fibromuscular dysplasia

We present a rare case of widespread fibromuscular dysplasia (FMD) involving the cervico-cephalic arteries associated with multiple dissections, saccular aneurysm and a carotid-cavernous sinus fistula (CCF). We also treat the CCF with combined coil embolism and stent graft implantation.

Article--Diagnosis and management of dural carotid–cavernous sinus fistulas

A carotid-cavernous sinus fistula (CCF) is an abnormal communication between the cavernous sinus and the carotid arterial system. Some fistulas are characterized by a direct connection between the cavernous segment of the internal carotid artery (ICA) and the cavernous sinus, whereas others consist of a communication between the cavernous sinus and one or more meningeal branches of the ICA, external carotid artery, or both. These dural fistulas usually have low rates of arterial blood flow and until recently were difficult to diagnose and treat. In this paper, the author discusses the anatomy, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of dural CCFs.

Transvenous embolization in treatment of refractory carotid-cavernous sinus fistula

To investigate the effects of transvenous embolization in treatment of refractory carotid-cavernous sinus fistula (CCF). Twenty-five patients of refractory CCF with 28 foci underwent transvenous embolization, femoral vein-inferior petrosal sinus approach was used in 12 of which, and femoral vein-facial vein-superior ophthalmic vein approach was used in 12 of which. The embolizing materials included controllable coils (GDC, EDC), free coil, and silk. Three to twenty-four months after the treatment angiography was conducted on 10 patients and telephone follow-up was conducted on the other 15 patients. Immediate complete angiographic obliteration of the fistula was achieved in 20 patients. Residual shunting was left in 5 patients, 2 with pterygoid drainage and 3 with inferior petrosal sinus drainage. Headache and vomiting were the common symptoms after embolization. The angiography during follow-up showed that there were residual shunting in 4 patients, residual inferior petrosal drainage in 1 patient, and residual pterygoid drainage in 1 patient, and that no reoccurrence was found in the 6 patients with complete angiographic obliteration. The patients undergoing telephone follow-up reported that they had not any symptom. Safe and effective, transvenous embolization can be the first choice after the failure in treatment of the carotid-cavernous sinus fistula.