scholarly journals Intra-Arterial Lidocaine Blunts the Trigeminocardiac Reflex during Endovascular Treatment of a Carotid-Cavernous Fistula

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Renee L. Coleman ◽  
Dmitri Bezinover ◽  
Douglas C. Jones ◽  
Kevin M. Cockroft ◽  
Uma R. Parekh
Keyword(s):  
Case Report ◽  
Cavernous Sinus ◽  
Hemodynamic Instability ◽  
Endovascular Embolization ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Trigeminocardiac Reflex ◽  
Intraoperative Management ◽  
Carotid Cavernous Fistulas ◽  
Neurovascular Structures

Carotid-cavernous fistulas (CCFs) are vascular shunts that allow blood to flow from the carotid artery or its branches into the cavernous sinus. Endovascular embolization is the treatment modality of choice. The trigeminocardiac reflex (TCR) is a vagally mediated reflex that can lead to hemodynamic instability. It can be activated during embolization procedures due to the proximity of vagal efferent neurovascular structures within the cavernous sinus. This case report describes the intraoperative management of recurrent, profound bradycardia due to TCR during endovascular CCF embolization.

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.

Direct arteriovenous fistula at the inferolateral trunk mimicking carotid cavernous fistula without involving the cavernous sinus: a case report

2011 ◽  
Vol 154 (3) ◽  
pp. 465-469 ◽  
Author(s):  
Nobutaka Horie ◽  
Minoru Morikawa ◽  
Gohei So ◽  
Kentaro Hayashi ◽  
Kazuhiko Suyama ◽  
...  
Keyword(s):  
Case Report ◽  
Arteriovenous Fistula ◽  
Cavernous Sinus ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Inferolateral Trunk

scholarly journals FISTULE CAROTIDO-CAVERNEUSE GEANTE POST-TRAUMATIQUEGIANT TRAUMATIC CAROTID-CAVERNOUS SINUS FISTULA

2020 ◽  
Vol 8 (10) ◽  
pp. 922-925
Author(s):  
M. El. Ikhloufi ◽  
◽  
N. Boutimzine ◽  
E. Cheikh ◽  
M. El Hassani ◽  
...  
Keyword(s):  
Young Patient ◽  
Cavernous Sinus ◽  
Road Accident ◽  
Impact Point ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Carotid Cavernous Sinus Fistula ◽  
Carotid Cavernous Fistulas

Carotid-cavernous fistulas are abnormal arteriovenous communications between the carotid system and the cavernous sinus [1]. They are rare but potentially serious, which can engage the functional and vital prognosis. We report the case of a young patient who presented a giant carotid-cavernous fistula following a road accident with a cranial impact point.

Carotid cavernous fistula: direct repair with preservation of the carotid artery

1973 ◽  
Vol 38 (1) ◽  
pp. 99-106 ◽  
Author(s):  
Dwight Parkinson
Keyword(s):  
Carotid Artery ◽  
Cavernous Sinus ◽  
Case Reports ◽  
Direct Approach ◽  
Illustrative Case ◽  
Carotid Cavernous Fistula ◽  
Content Type ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas ◽  
Fine Print

✓ The techniques and advantages of the direct approach to carotid cavernous fistulas with repair of the fistula and preservation of the carotid artery are discussed with illustrative case reports. The surgical significance of the anatomy of the parasellar venous structures and their relationship to the carotid artery are discussed. Two points emphasized are that it is possible to operate within the cavernous sinus and still be outside both the venous and arterial components of the fistula, and that, by one means or another, the carotid should be preserved.

scholarly journals Unilateral Direct Carotid Cavernous Fistula Causing Bilateral Ocular Manifestation

2015 ◽  
Vol 6 (3) ◽  
pp. 482-487 ◽  
Author(s):  
Zeferino Demartini Jr. ◽  
Fernando Liebert ◽  
Luana Antunes Maranha Gatto ◽  
Thiago Simiano Jung ◽  
Carlos Rocha Jr. ◽  
...  
Keyword(s):  
Cavernous Sinus ◽  
Internal Carotid ◽  
Interventional Neuroradiology ◽  
Artery Wall ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Bilateral Presentation ◽  
Carotid Cavernous Sinus Fistula ◽  
Carotid Cavernous Fistulas ◽  
Direct Carotid Cavernous Fistula

Unilateral carotid cavernous fistula presents with ipsilateral ocular findings. Bilateral presentation is only seen in bilateral fistulas, usually associated with indirect (dural) carotid cavernous fistulas. Direct carotid cavernous fistulas are an abnormal communication between the internal carotid artery and the cavernous sinus. They typically begin with a traumatic disruption in the artery wall into the cavernous sinus, presenting with a classic triad of unilateral pulsatile exophthalmos, cranial bruit and episcleral venous engorgement. We report the case of a 38-year-old male with traumatic right carotid cavernous sinus fistula and bilateral ocular presentation successfully treated by interventional neuroradiology.

scholarly journals Long Term Post Traumatic High Flow Carotid Cavernous Fistula with Patent Collateral Vessel : A Case Report

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Luthfy Farhan ◽  
Ridha Dharmajaya
Keyword(s):  
Case Report ◽  
Left Hemisphere ◽  
Cavernous Sinus ◽  
Craniocerebral Trauma ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Left Brain ◽  
History Of ◽  
Carotid Cavernous Sinus Fistula ◽  
The Right

Introduction : A carotid-cavernous sinus fistula (CCF) is an abnormal communication between arteries and veins within the cavernous sinus. Carotid cavernous fistula (CCF) is a very rare case it's difficult to diagnose. because most CCF patients rarely come for treatment. Case Report : A 33-year-old male presented with history of protrusion of Left eye ball, and double vision for the last 2 years. visual disturbances were found in the right eye for 2 years, blurry vision is increasingly. Bruit was audible in orbital region on the left side. DSA showed that there was a fistula in the left sinus cavernous region, the arteries in the left area showed inadequate to direct the left hemisphere, but in the right arety showed that the right artery was adversely affected right and left brain. Discussion : Traumatic CCFs are the most common type, accounting for up to 75% of all CCFs.87 They have been reported to occur in 0.2% of patients with craniocerebral trauma and in up to 4% of patients who sustain a basilar skull fractur.2 The symptoms and signs of CCF always include eyelid swelling, proptosis, chemosis, and hyperaemia, dilated of vessel and the condition is commonly misdiagnosed as Graves’ophthal-mopathy or inflammatory conjunctivitis.3Cerebral angiography is the gold standard for the definitive diagnosis, classification, and planning of endovascular intervention in CCFs. Angiographic results in this patient showed a fistula in the left cavernous sinus and inadequate supply of the left artery to the left hemisphere. Conclusion : This case is very unique because the left brain gets blood supply from the right carotid system, with the left carotid artery system inadequate to direct the left hemisphere because of the carotid cavernous fistula on the left side

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.

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 Transarterial Embolization of an Indirect Carotid- Cavernous Fistula with N-Butyl Cyanoacrylate

2018 ◽  
Vol 25 (2) ◽  
pp. 150-156
Author(s):  
Matías Negrotto ◽  
Roberto Crosa ◽  
Alejandra Jaume ◽  
Fiorella Casanova
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Internal Carotid ◽  
Transarterial Embolization ◽  
External Carotid Artery ◽  
External Carotid ◽  
Carotid Cavernous Fistula ◽  
Cavernous Fistula ◽  
Carotid Cavernous Fistulas

Carotid-cavernous fistulas are vascular shunts that allow blood to flow from the carotid artery into the cavernous sinus. Some fistulas are characterized by a direct connection between the cavernous segment of the internal carotid artery and the cavernous sinus. Other carotid-cavernous fistulas are dural, consisting of a communication between the cavernous sinus and one or more meningeal branches of the internal carotid artery, the external carotid artery, or both. Endovascular management is the treatment modality of choice in these cases. We report the use of N-butyl cyanoacrylate in a successful transarterial embolization of a dural carotid-cavernous fistula fed by arterial branches of the internal -and mainly- external carotid arteries (Barrow type D).

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.

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