scholarly journals Venous Drainage Patterns in Carotid Cavernous Fistulas

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ayse Aralasmak ◽  
Kamil Karaali ◽  
Can Cevikol ◽  
Utku Senol ◽  
Timur Sindel ◽  
...  
Keyword(s):  
Treatment Approach ◽  
Imaging Techniques ◽  
Venous Drainage ◽  
High Flow ◽  
Digital Subtraction ◽  
Carotid Cavernous Fistula ◽  
Drainage Patterns ◽  
Carotid Cavernous Fistulas ◽  
Mixed Types ◽  
Anterior Posterior

Purpose. The carotid-cavernous fistula (CCF) is an abnormal arteriovenous communication and its drainage pathways may affect the clinic presentation and change treatment approach. We evaluated drainage patterns of CCFs by digital subtraction angiography (DSA) and categorized drainage pathways according to their types and etiology. Materials and Methods. Venous drainage patterns of 13 CCFs from 10 subjects were studied and categorized as anterior, posterior, superior, inferior, and contralateral on DSA. Drainage patterns were correlated to types and etiology of CCFs. Diagnosis of CCFs was first made by noninvasive imaging techniques. Results. On DSA, traumatic CCFs were usually high flow, direct type while spontaneous CCFs were usually slow flow, indirect type. Bilaterality and mixed types were observed among the indirect spontaneous CCFs. In all CCFs, anterior and inferior drainages were the most common. Contrary to the literature, posterior and superior drainages were noted only in high flow and long standing direct fistulas. Contralateral drainage was not observed in all, supporting plausible compartmentalization of cavernous sinuses. Conclusion. Types, etiology, and duration of the CCFs may affect their drainage patterns. DSA is valuable for categorization of CCFs and verification of drainage patterns. Drainage pathways may affect the clinic presentation and also change treatment approach.

scholarly journals Endovascular treatment of carotid-cavernous fistula type A with platinium coils

2008 ◽  
Vol 65 (12) ◽  
pp. 923-926 ◽  
Author(s):  
Slobodan Culafic ◽  
Robert Juszkat ◽  
Sinisa Rusovic ◽  
Dara Stefanovic ◽  
Ljubodrag Minic ◽  
...  
Keyword(s):  
Type A ◽  
Endovascular Embolization ◽  
High Flow ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Vertebrobasilar Artery ◽  
Eye Symptoms ◽  
The Right ◽  
Carotid Cavernous Fistulas ◽  
Platinum Coils

Background. Carotid-cavernous fistulas are abnormal communications between carotid arteries or their branches and the cavernous system caused mostly by trauma. Posttraumatic fistulas represent 70% of all carotid-cavernous fistulas and they are mostly high-flow shunts (type A). This type gives characteristic eye symptoms. Case report. This paper presents a 44-year old male patient with carotidcavernous fistula as a result of penetrating head injury. In clinical presentation the patient had exophthalmos, conjunctival chemosis and weakening of vision on the right eye, headache and diplopia. Digital subtracted angiography showed high-flow carotid-cavernous fistula, which was vascularised from the left carotid artery and from vertebrobasilar artery. Endovascular embolization with platinum coils was performed through the transarterial route (endoarterial approach). Check angiogram confirmed that the fistula was closed and that no new communications developed. Conclusion. Embolization of complex carotidcavernous fistula type A was successfully performed with platinum coils by endovascular approach.

Detection of Predictors of Hemorrhage in Patients with Cerebral Arteriovenous Malformation by Digital Subtraction Angiography

2019 ◽  
Vol 8 (2) ◽  
pp. 87-92
Author(s):  
Fazlul Haque ◽  
Shariful Islam ◽  
Monzurul Haque ◽  
Shafiul Alam ◽  
Raziul Haque
Keyword(s):  
Arteriovenous Malformation ◽  
Digital Subtraction Angiography ◽  
Venous Drainage ◽  
High Flow ◽  
Cerebral Arteriovenous Malformation ◽  
P Value ◽  
Digital Subtraction ◽  
College Hospital ◽  
Multiple Imaging ◽  
Arterial Feeder

Background: Cerebral arteriovenous malformation (AVM) is a complex tangled of dilated blood vessels in which arteries flow directly into veins without capillaries. The main cause of death in patients with cerebral AVM is intraparenchymal hemorrhage. There are multiple imaging tools that can detect the predictors of hemorrhage in cerebralarteriovenous malformation. But nowadays digital subtraction angiography (DSA) is playing a wonderful role to detect these predictors. Objectives: To detect the common predicting factors of hemorrhage from in brain by DSA. Methodology:This observational cross-sectional study was carried out in the department of Neurosurgery, Dhaka Medical College Hospital and study period was from October, 2014 to March, 2016. 76 patients of hemorrhagic stroke with clinical and radiological (CT scan) suspicion of ruptured cerebral AVM were selected by non-probability purposive sampling technique. After that enrolled patients were scrutinized according to selection criteria. Finally selected 50 patients who underwent DSA and were positive for AVM were included in this study. All the included patients’ demographic, clinical and DSA profile were recorded in pre-structured data collection sheet. All the data were compiled, edited and plotted in tabular and figure forms. Data analysis was done by chi-square test. P value was determined significant when it was <0.05. Results: In angiographic presentation, maximum cases were found deep seated (72%), small sized (<3 cm) (70%), having compact type of nidus (58%), having superficial arterial feeder (62%), having high flow draining vein (70%), having deep venous drainage (56%) and single draining vein (78%). Associated aneurysm and venous ectasia were 12% and 4% respectively. The statistically significant predictors were deep location (P=0.036) and superficial arterial feeder (P=0.03) between male and female subjects. Conclusion: Our results showed that small sized, deep-seated Cerebral arteriovenous malformation, having high flow draining vein, having deep venous drainage and single number of draining vein are the possible causes of hemorrhage. Lesions that have associated aneurysms have a risk of bleeding. Bang. J Neurosurgery 2019; 8(2): 87-92

Dural Arteriovenous Fistulas with Venous Drainage Patterns Inducing Ocular Manifestations Mimicking a Carotid Cavernous Fistula: Report of 2 Cases

2019 ◽  
Vol 127 ◽  
pp. 216-219 ◽  
Author(s):  
Mohammad Ghorbani ◽  
Sina Asaadi ◽  
Christoph Wipplinger ◽  
Christoph J. Griessenauer ◽  
Fatemeh Zangi-Abadi ◽  
...  
Keyword(s):  
Venous Drainage ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Arteriovenous Fistulas ◽  
Ocular Manifestations ◽  
Drainage Patterns ◽  
Dural Arteriovenous Fistulas

Treatment of a carotid cavernous fistula via direct transovale cavernous sinus puncture

2013 ◽  
Vol 119 (1) ◽  
pp. 247-251 ◽  
Author(s):  
Alberto Gil ◽  
Luis López-Ibor ◽  
Gerardo Lopez-Flores ◽  
Hugo Cuellar ◽  
Eduardo Murias ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Venous Drainage ◽  
Foramen Ovale ◽  
Superior Ophthalmic Vein ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Complete Obliteration ◽  
Feasible Alternative ◽  
Carotid Cavernous Fistulas

Endovascular treatment is the treatment of choice for indirect carotid cavernous fistulas (CCFs). Direct surgical obliteration of CCFs is recommended in highly symptomatic patients or in those with an aggressive pattern of venous drainage. However, this is a technically challenging approach associated with significant procedural morbidity. The authors present a case in which they decided to attempt a novel access to the cavernous sinus through the foramen ovale before recommending surgery for an otherwise untreatable dural CCF. This 52-year-old man with an indirect CCF and neurological deficit had undergone several attempts to embolize the shunt by means of the standard approaches. Ultimately direct cavernous sinus access was obtained through the foramen ovale, resulting in complete obliteration of the shunt. The occlusion was radiographically stable at the 6-month follow-up evaluation, and the patient has remained asymptomatic. Percutaneous transovale puncture of a CCF is a feasible alternative to accessing the cavernous sinus when traditional transvenous catheterization or direct superior ophthalmic vein approach is not possible.

Carotid-Cavernous Fistula

2019 ◽  
pp. 219-224
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Carotid Artery ◽  
Cerebral Angiography ◽  
Definitive Diagnosis ◽  
Digital Subtraction ◽  
Conjunctival Injection ◽  
Carotid Cavernous Fistula ◽  
Management Options ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas ◽  
Symptoms And Signs

Carotid-cavernous fistulas are abnormal vascular communications between the carotid artery or its branches and the cavernous sinus. They often present with visual symptoms and signs, such as proptosis, chemosis, diplopia, or conjunctival injection. In this chapter, we begin by reviewing the types of carotid-cavernous fistula and their respective causes. We next discuss the symptoms, signs, and potential complications of carotid-cavernous fistula. We then discuss noninvasive imaging approaches for the diagnostic evaluation of carotid-cavernous fistula, although digital subtraction cerebral angiography is necessary for definitive diagnosis. Lastly, we review the management options for carotid cavernous fistula, including approaches that can minimize or address potential visual complications.

scholarly journals Use of coronary stent grafts for the treatment of high-flow carotid cavernous fistula

2021 ◽  
Vol 14 (11) ◽  
pp. e245922
Author(s):  
Ivo Petrov ◽  
Zoran Stankov ◽  
Damyan Boychev ◽  
Marko Klissurski
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
High Flow ◽  
Coronary Stent ◽  
Parent Artery ◽  
Covered Stents ◽  
Stent Grafts ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas

Carotid cavernous fistulas are abnormal communications between the carotid artery or its branches and the cavernous sinus. It can be traumatic or spontaneous. The widely accepted treatment is by detachable balloons. Advancements in the field of endovascular medicine made available other options for the treatment of this condition. Covered stents are widely available and offer preservation of the parent artery while occluding the fistula.

scholarly journals Spontaneous Resolution of Post-Traumatic Direct Carotid-Cavernous Fistula

2017 ◽  
Vol 7 (1-2) ◽  
pp. 1-5 ◽  
Author(s):  
Varun Naragum ◽  
Glenn Barest ◽  
Mohamad AbdalKader ◽  
Katharine M. Cronk ◽  
Thanh N. Nguyen
Keyword(s):  
Carotid Artery ◽  
Endovascular Embolization ◽  
High Flow ◽  
Spontaneous Resolution ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Post Traumatic ◽  
Cavernous Carotid Artery ◽  
Carotid Cavernous Fistulas ◽  
Direct Carotid Cavernous Fistula

Post-traumatic carotid-cavernous fistulas are due to a tear in the wall of the cavernous carotid artery, leading to shunting of blood into the cavernous sinus. These are generally high-flow fistula and rarely resolve spontaneously. Most cases require endovascular embolization. We report a case of Barrow type A carotid-cavernous fistula which resolved spontaneously.

scholarly journals Low-Flow Direct Carotid-Cavernous Fistula Caused by Rupture of an Intracavernous Carotid Aneurysm

2014 ◽  
Vol 20 (4) ◽  
pp. 476-481 ◽  
Author(s):  
I-Chang Su ◽  
Juan Pablo Cruz ◽  
Timo Krings
Keyword(s):  
Rare Case ◽  
High Flow ◽  
Low Flow ◽  
Clinical Scenario ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas ◽  
Direct Carotid Cavernous Fistula

Direct carotid-cavernous fistulas (CCFs) secondary to a ruptured intracavernous carotid aneurysm (ICCA) are usually high-flow lesions. On very rare occasions, a ruptured ICCA may present as a low-flow CCF, which poses a diagnostic and therapeutic dilemma whether the aneurysm and the observed fistula are causally related. Herein, we describe a rare case in which a ruptured ICCA resulted in a low-flow CCF. We demonstrated our approach to clarify this clinical scenario, and also propose a possible pathomechanism to explain the existence of low-flow direct CCF.

Experiences with surgical thrombosis of intracranial berry aneurysms and carotid cavernous fistulas

1974 ◽  
Vol 41 (6) ◽  
pp. 657-670 ◽  
Author(s):  
Sean Mullan
Keyword(s):  
Blood Flow ◽  
Intracranial Aneurysm ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Blood Flow ◽  
Giant Intracranial Aneurysm ◽  
Surgical Methods ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ The results of 61 cases of stereotaxic thrombosis of intracranial berry aneurysms indicate that the technique in selected cases is comparable to, but not necessarily superior to standard surgical methods. The results of wire-induced thrombosis in 15 cases of giant intracranial aneurysm suggest that this method is effective in situations where clipping and encapsulation are inapplicable. The results of thrombosis in six cases of carotid cavernous fistula suggest that intracavernous wire thrombosis may prove to be the treatment of choice in that it seals the fistula without impairing carotid blood flow.

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